Incidental identification of inv(16)(p13.1q22)/ CBFB- MYH11 variant transcript in a patient with therapy-related acute myeloid leukemia by routine leukemia translocation panel screen: implications for diagnosis and therapy

Cold Spring Harb Mol Case Stud. 2021 Jun 11;7(3):a006084. doi: 10.1101/mcs.a006084. Print 2021 Jun.

Abstract

A 52-yr-old woman presented with therapy-related acute myeloid leukemia. A bone marrow biopsy showed 21% blasts with a myeloid phenotype and no other notable features such as abnormal eosinophils. Routine nanofluidics-based reverse transcriptase polymerase chain reaction (PCR) leukemia translocation panel designed to screen for recurrent genetic abnormalities in acute leukemia detected an inversion 16 transcript variant E. This prompted rereview of karyotype and fluorescence in situ hybridization studies, which confirmed inv(16), leading to appropriate prognostication and modification of treatment. This case underscores the utility of a powerful molecular screening method for the routine detection of recurrent genetic abnormalities of acute myeloid leukemia. It was especially useful in this case because of the lack of characteristic morphologic findings seen in inversion 16 and the difficulty in its detection by conventional karyotype analysis.

Keywords: acute myeloid leukemia; hematological neoplasm.

Publication types

  • Case Reports

MeSH terms

  • Bone Marrow / pathology
  • Chromosome Inversion
  • Chromosomes, Human, Pair 16
  • Core Binding Factor beta Subunit / genetics*
  • Female
  • Hematologic Neoplasms / genetics
  • Humans
  • In Situ Hybridization, Fluorescence
  • Leukemia, Myeloid, Acute / diagnosis
  • Leukemia, Myeloid, Acute / genetics*
  • Leukemia, Myeloid, Acute / pathology
  • Leukemia, Myeloid, Acute / therapy
  • Middle Aged
  • Myosin Heavy Chains / genetics*
  • Oncogene Proteins, Fusion / genetics
  • Translocation, Genetic*

Substances

  • CBFB protein, human
  • Core Binding Factor beta Subunit
  • MYH11 protein, human
  • Oncogene Proteins, Fusion
  • Myosin Heavy Chains