Acute Myelomonocytic Leukemia (M4) with t (6; 9) (p23; q34) Followed by Detection of Minimal Residual Disease Using DEK-CAN mRNA

• Published in: The Japanese Journal of Pediatric Hematology Vol. 12; no. 3; pp. 190 - 194
• Main Authors: BESSHO, Fumio, YANAGISAWA, Masayoshi, TABUCHI, Ken, FENG, Xu, TATSUMI, Ken, HAYASHI, Yasuhide, OHNISHI, Hiroaki, KOBAYASHI, Miyuki
• Format: Journal Article
• Language: Japanese
• Published: THE JAPANESE SOCIETY OF PEDIATRIC HEMATOLOGY/ONCOLOGY 1998; 特定非営利活動法人 日本小児血液・がん学会
• Subjects: acute leukemia; AMMoL; clinical feature; DEK-CAN; RT-PCR; t (6 ; 9)
• ISSN: 0913-8706; 1884-4723
• DOI: 10.11412/jjph1987.12.190

We report on a six-year-old boy who was admitted to our hospital because of high fever and exanthema. He was found to have acute myelomonocytic leukemia (AMMoL) (FAB-M4) without bone marrow basophilia. A cytogenetic analysis of bone marrow blasts revealed t (6; 9) (p23; q34). He was treated with induction therapy consisting of cytarabine, mitoxantrone and etoposide, and attained complete remission. After 8 courses of intensification therapy, chemotherapy was completed. However, 2 months later he relapsed, and the disease became resistant to chemotherapy. He died of sepsis 20 months after the diagnosis. DEK-CAN chimeric mRNA was detected both at the time of diagnosis and during hematologic remission by reverse transcriptase-polymerase chain reaction. The poor clinical outcome of our case was compatible to with previous reports of leukemia with t (6; 9). More intensive treatment, including bone marrow transplantation in the first remission, should be considered to improve the prognosis of this type of leukemia. The etiology and clinical features of t (6; 9) acute leukemia are also discussed.