| Molecular Cytogenetics | |
| A novel acquired inv(2)(p23.3q24.3) with concurrent submicroscopic deletions at 2p23.3, 2p22.1, 2q24.3 and 1p13.2 in a patient with chronic thrombocytopenia and anemia | |
| Eigil Kjeldsen1  | |
| [1] HemoDiagnostic Laboratory, CancerCytogenetic Section, Department of Hematology, Aarhus University Hospital, Tage-Hansens Gade 2, Ent. 4A, Aarhus C, DK-8000, Denmark | |
| 关键词: aCGH; Microdeletion; Inversion; Chromosome 2; Anemia; Thrombocytopenia; | |
| Others : 1132191 DOI : 10.1186/s13039-015-0113-z |
|
| received in 2015-01-02, accepted in 2015-01-20, 发布年份 2015 | |
PDF
|
|
【 摘 要 】
Background
Thrombocytopenia can result from a wide range of conditions and may be determined by multiple mechanisms. It can be due to a reduced platelet production or an increased destruction of platelets. Increased destruction is seen in conditions such as disseminated intravascular coagulation (DIC) and thrombotic microangiopathies, whereas decreased production is seen in bone marrow (BM) failure syndromes such as aplastic anemia, myelodysplastic syndromes, and chemotherapy-induced thrombocytopenia. In BM failure syndromes thrombocytopenia is often accompanied by anemia and/or leucopenia. Recognition of the cause of thrombocytopenia is often crucial for correct management of patients.
Case presentation
Here, we report on a 71 year-old male caucasian with thrombocytopenia since six years, and a recent development of anemia. At the time of progression with anemia a bone marrow sampling was done to examine for a possible causative myeloid malignancy. The morphological examination was normal whereas immunophenotyping by flowcytometry could not exclude myelodysplasia. Cytogenetic analysis by G-banding revealed a pericentric inversion of chromosome 2 in 23 out of 25 analyzed metaphases. The inversion was further characterized by molecular cytogenetics and high-resolution oligo-based array-CGH analysis. Together the analyses demonstrated a 141.8 Mb pericentric inversion, inv(2)(p23.3q24.3), and concurrent submicroscopic deletions in 2p23.3, 2p22.1, 2q24.3 and 1p13.2 between 0.6-1.9 Mb in size. Locus-specific FISH analyses confirmed all deletions and the pericentric inversion of chromosome 2. The chromosomal abnormalities were present in 87% of the bone marrow cells whereas analysis of a skin biopsy revealed a normal male karyotype as well as a normal array-CGH result. These findings demonstrate that the identified abnormalities were acquired.
Conclusion
To the best of our knowledge, this is the first report of chronic thrombocytopenia and anemia associated with acquired inv(2)(p23.3q24.3) as a sole cytogenetic abnormality together with concurrent submicroscopic deletions at 2p23.3, 2p22.1, 2q24.3 and 1p13.2.
【 授权许可】
2015 Kjeldsen; licensee BioMed Central.
【 预 览 】
| Files | Size | Format | View |
|---|---|---|---|
| 20150303150225735.pdf | 2804KB | ||
| Figure 4. | 50KB | Image | |
| Figure 3. | 56KB | Image | |
| Figure 2. | 62KB | Image | |
| Figure 1. | 25KB | Image |
【 图 表 】
Figure 1.
Figure 2.
Figure 3.
Figure 4.
【 参考文献 】
- [1]Kistangari G, McCrae KR: Immune thrombocytopenia. Hematol Oncol Clin North Am 2013, 27:495-520.
- [2]Smock KJ, Perkins SL: Thrombocytopenia: an update. Int J Lab Hematol 2014, 36:269-78.
- [3]Bryan J, Jabbour E, Prescott H, Kantarjian H: Thrombocytopenia in patients with myelodysplastic syndromes. Semin Hematol 2010, 47:274-80.
- [4]Swerdlow SH: WHO Classification of tumours of haematopoitic and lymphoid tissues, 4th edn. Lyon: International Agency for Research on Cancer (IARC); 2008.
- [5]Grimwade D, Mrozek K: Diagnostic and prognostic value of cytogenetics in acute myeloid leukemia. Hematol Oncol Clin North Am 2011, 25:1135-61.
- [6]Byrd JC, Mrozek K, Dodge RK, Carroll AJ, Edwards CG, Arthur DC, et al.: Pretreatment cytogenetic abnormalities are predictive of induction success, cumulative incidence of relapse, and overall survival in adult patients with de novo acute myeloid leukemia: results from Cancer and Leukemia Group B (CALGB 8461). Blood 2002, 100:4325-36.
- [7]Suciu S, Mandelli F, de Witte T, Zittoun R, Gallo E, Labar B, et al.: Allogeneic compared with autologous stem cell transplantation in the treatment of patients younger than 46 years with acute myeloid leukemia (AML) in first complete remission (CR1): an intention-to-treat analysis of the EORTC/GIMEMAAML-10 trial. Blood 2003, 102:1232-40.
- [8]Greenberg PL: Molecular and genetic features of myelodysplastic syndromes. Int J Lab Hematol 2012, 34:215-22.
- [9]Klopocki E, Schulze H, Strauss G, Ott CE, Hall J, Trotier F, et al.: Complex inheritance pattern resembling autosomal recessive inheritance involving a microdeletion in thrombocytopenia-absent radius syndrome. Am J Hum Genet 2007, 80:232-40.
- [10]Albers CA, Paul DS, Schulze H, Freson K, Stephens JC, Smethurst PA, et al.: Compound inheritance of a low-frequency regulatory SNP and a rare null mutation in exon-junction complex subunit RBM8A causes TAR syndrome. Nat Genet 2012, 44:435-9.
- [11]Kjeldsen E, Roug AS: A novel unbalanced de novo translocation der (5) t (4;5) (q26;q21.1) in adult T-cell precursor lymphoblastic leukemia. Mol Cytogenet 2012, 5:21. BioMed Central Full Text
- [12]ISCN: An International System for Human Cytogenetic Nomenclature (2013). S. Karger and Cytogenetic and Genome Research, Basel; 2013.
- [13]Mitelman F, Johansson B, Mertens FE: Mitelman Database of Chromosome Aberrations and Gene Fusions in Cancer. http://cgap.nci.nih.gov/Chromosomes/Mitelman. Last update August 18 2014.
- [14]Gardner RJM, Sutherland GR: Chromosome Abnormalities and Genetic Counseling. Oxford University Press, New York; 1996.
- [15]Kaiser-Rogers K, Rao K: Structural Chromosome Rearrangements. In The Principles of Clinical Cytogenetics. Edited by Gersen SL, Keagle MB. Humana Press, New Jersey; 2005:165-206.
- [16]Fonatsch C, Gudat H, Lengfelder E, Wandt H, Silling-Engelhardt G, Ludwig WD, et al.: Correlation of cytogenetic findings with clinical features in 18 patients with inv (3) (q21q26) or t (3;3) (q21;q26). Leukemia 1994, 8:1318-26.
- [17]Morishita K, Parganas E, Matsugi T, Ihle JN: Expression of the Evi-1 zinc finger gene in 32Dc13 myeloid cells blocks granulocytic differentiation in response to granulocyte colony-stimulating factor. Mol Cell Biol 1992, 12:183-9.
- [18]Arai Y, Hosoda F, Kobayashi H, Arai K, Hayashi Y, Kamada N, et al.: The inv(11)(p15q22) chromosome translocation of de novo and therapy-related myeloid malignancies results in fusion of the nucleoporin gene, NUP98, with the putative RNA helicase gene, DDX10. Blood 1997, 89:3936-44.
- [19]Liu P, Tarle SA, Hajra A, Claxton DF, Marlton P, Freedman M, et al.: Fusion between transcription factor CBF beta/PEBP2 beta and a myosin heavy chain in acute myeloid leukemia. Science 1993, 261:1041-4.
- [20]Ma Z, Cools J, Marynen P, Cui X, Siebert R, Gesk S, et al.: Inv(2)(p23q35) in anaplastic large-cell lymphoma induces constitutive anaplastic lymphoma kinase (ALK) tyrosine kinase activation by fusion to ATIC, an enzyme involved in purine nucleotide biosynthesis. Blood 2000, 95:2144-9.
- [21]Soda M, Choi YL, Enomoto M, Takada S, Yamashita Y, Ishikawa S, et al.: Identification of the transforming EML4-ALK fusion gene in non-small-cell lung cancer. Nature 2007, 448:561-6.
- [22]Zhang F, Carvalho CM, Lupski JR: Complex human chromosomal and genomic rearrangements. Trends Genet TIG 2009, 25:298-307.
- [23]Stephens PJ, Greenman CD, Fu B, Yang F, Bignell GR, Mudie LJ, et al.: Massive genomic rearrangement acquired in a single catastrophic event during cancer development. Cell 2011, 144:27-40.
- [24]Woo RA, Poon RY: Activated oncogenes promote and cooperate with chromosomal instability for neoplastic transformation. Genes Dev 2004, 18:1317-30.
- [25]Spruck CH, Won KA, Reed SI: Deregulated cyclin E induces chromosome instability. Nature 1999, 401:297-300.
- [26]Sakofsky CJ, Ayyar S, Malkova A: Break-induced replication and genome stability. Biogeosciences 2012, 2:483-504.
- [27]Okano M, Bell DW, Haber DA, Li E: DNA methyltransferases Dnmt3a and Dnmt3b are essential for de novo methylation and mammalian development. Cell 1999, 99:247-57.
- [28]Hopfer O, Komor M, Koehler IS, Freitag C, Schulze M, Hoelzer D, et al.: Aberrant promotor methylation in MDS hematopoietic cells during in vitro lineage specific differentiation is differently associated with DNMT isoforms. Leuk Res 2009, 33:434-42.
- [29]Mayle A, Yang L, Rodriguez B, Zhou T, Chang E, Curry CV, Challen GA, Li W, Wheeler D, Rebel VI, Goodell MA: Dnmt3a loss predisposes murine hematopoietic stem cells to malignant transformation. Blood 2014.
- [30]Chen L, Zhang A, Li Y, Zhang K, Han L, Du W, et al.: MiR-24 regulates the proliferation and invasion of glioma by ST7L via beta-catenin/Tcf-4 signaling. Cancer Lett 2013, 329:174-80.
- [31]Lindquist D, Kvarnbrink S, Henriksson R, Hedman H: LRIG and cancer prognosis. Acta Oncol 2014, 53:1135-42.
- [32]Jerez A, Gondek LP, Jankowska AM, Makishima H, Przychodzen B, Tiu RV, et al.: Topography, clinical, and genomic correlates of 5q myeloid malignancies revisited. J Clin Oncol 2012, 30:1343-9.
- [33]Stoddart A, Fernald AA, Wang J, Davis EM, Karrison T, Anastasi J, et al.: Haploinsufficiency of del(5q) genes, Egr1 and Apc, cooperate with Tp53 loss to induce acute myeloid leukemia in mice. Blood 2014, 123:1069-78.
- [34]Favier R, Douay L, Esteva B, Portnoi MF, Gaulard P, Lecompte T, et al.: A novel genetic thrombocytopenia (Paris-Trousseau) associated with platelet inclusions, dysmegakaryopoiesis and chromosome deletion AT 11q23. C R Acad Sci III 1993, 316:698-701.
- [35]Breton-Gorius J, Favier R, Guichard J, Cherif D, Berger R, Debili N, et al.: A new congenital dysmegakaryopoietic thrombocytopenia (Paris-Trousseau) associated with giant platelet alpha-granules and chromosome 11 deletion at 11q23. Blood 1995, 85:1805-14.
PDF