Do cytogenetic abnormalities precede morphologic abnormalities in a developing malignant condition?

Jill K. Northup, Swarupa A. Gadre, Yimin Ge, Lillian Lockhart, Gopalrao V N Velagaleti

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Cytogenetic evaluation of bone marrow and neoplastic tissues plays a critical role in determining patient management and prognosis. Here, we highlight two cases in which the cytogenetic studies challenge the common practice of using hematologic and morphologic changes as key factors in malignant disease management. The first case is that of a lymph node sample from a 40-yr-old non-Hodgkin's lymphoma (NHL) patient sent for determination of disease progress. Hematologic studies showed no evidence of transformation to high-grade NHL (>15% blasts with rare mitotic figures). Cytogenetic studies of lymph node showed multiple clonal abnormalities, most notably a der(18) from a t(14;18) which is associated with high-grade NHL. After two cycles of chemotherapy with fludarabine, the patient did not show any clinical response, suggesting possible progression to high-grade lymphoma. The second case is of a patient with a history of human immunodeficiency virus and blastic natural killer leukemia/lymphoma. Hematologic studies of ascitic fluid classified the patient as having pleural effusion lymphoma whereas bone marrow analysis showed no malignancy. Bone marrow cytogenetic studies showed multiple clonal abnormalities including a t(8;14), which is commonly associated with Burkitt's lymphoma (BL). To our knowledge, this is the first case wherein a morphologically normal bone marrow showed presence of clonal abnormalities consistent with BL or Pleural effusion lymphoma. After two cycles of CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) chemotherapy, the patient's general condition and ascitis improved and she was discharged. These studies clearly demonstrate that genetic changes often precede morphologic changes in a developing malignant condition. Therefore, the critical information needed for care of patients with malignant disorders may be incomplete or inaccurate if cytogenetic evaluation is overlooked.

Original languageEnglish (US)
Pages (from-to)152-156
Number of pages5
JournalEuropean Journal of Haematology
Volume78
Issue number2
DOIs
StatePublished - Feb 2007

Fingerprint

Chromosome Aberrations
Non-Hodgkin's Lymphoma
Cytogenetics
Bone Marrow
Multiple Abnormalities
Lymphoma
Burkitt Lymphoma
Pleural Effusion
Lymph Nodes
Drug Therapy
Ascitic Fluid
Vincristine
Disease Management
Prednisone
Doxorubicin
Cyclophosphamide
Patient Care
Leukemia
HIV
Neoplasms

Keywords

  • Burkitt's lymphoma
  • Clonal abnormalities
  • Primary effusion lymphoma
  • Transformation
  • Translocation

ASJC Scopus subject areas

  • Hematology

Cite this

Do cytogenetic abnormalities precede morphologic abnormalities in a developing malignant condition? / Northup, Jill K.; Gadre, Swarupa A.; Ge, Yimin; Lockhart, Lillian; Velagaleti, Gopalrao V N.

In: European Journal of Haematology, Vol. 78, No. 2, 02.2007, p. 152-156.

Research output: Contribution to journalArticle

Northup, Jill K. ; Gadre, Swarupa A. ; Ge, Yimin ; Lockhart, Lillian ; Velagaleti, Gopalrao V N. / Do cytogenetic abnormalities precede morphologic abnormalities in a developing malignant condition?. In: European Journal of Haematology. 2007 ; Vol. 78, No. 2. pp. 152-156.
@article{4a4015303c5d4742807998d053ed1097,
title = "Do cytogenetic abnormalities precede morphologic abnormalities in a developing malignant condition?",
abstract = "Cytogenetic evaluation of bone marrow and neoplastic tissues plays a critical role in determining patient management and prognosis. Here, we highlight two cases in which the cytogenetic studies challenge the common practice of using hematologic and morphologic changes as key factors in malignant disease management. The first case is that of a lymph node sample from a 40-yr-old non-Hodgkin's lymphoma (NHL) patient sent for determination of disease progress. Hematologic studies showed no evidence of transformation to high-grade NHL (>15{\%} blasts with rare mitotic figures). Cytogenetic studies of lymph node showed multiple clonal abnormalities, most notably a der(18) from a t(14;18) which is associated with high-grade NHL. After two cycles of chemotherapy with fludarabine, the patient did not show any clinical response, suggesting possible progression to high-grade lymphoma. The second case is of a patient with a history of human immunodeficiency virus and blastic natural killer leukemia/lymphoma. Hematologic studies of ascitic fluid classified the patient as having pleural effusion lymphoma whereas bone marrow analysis showed no malignancy. Bone marrow cytogenetic studies showed multiple clonal abnormalities including a t(8;14), which is commonly associated with Burkitt's lymphoma (BL). To our knowledge, this is the first case wherein a morphologically normal bone marrow showed presence of clonal abnormalities consistent with BL or Pleural effusion lymphoma. After two cycles of CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) chemotherapy, the patient's general condition and ascitis improved and she was discharged. These studies clearly demonstrate that genetic changes often precede morphologic changes in a developing malignant condition. Therefore, the critical information needed for care of patients with malignant disorders may be incomplete or inaccurate if cytogenetic evaluation is overlooked.",
keywords = "Burkitt's lymphoma, Clonal abnormalities, Primary effusion lymphoma, Transformation, Translocation",
author = "Northup, {Jill K.} and Gadre, {Swarupa A.} and Yimin Ge and Lillian Lockhart and Velagaleti, {Gopalrao V N}",
year = "2007",
month = "2",
doi = "10.1111/j.1600-0609.2006.00798.x",
language = "English (US)",
volume = "78",
pages = "152--156",
journal = "European Journal of Haematology",
issn = "0902-4441",
publisher = "Wiley-Blackwell",
number = "2",

}

TY - JOUR

T1 - Do cytogenetic abnormalities precede morphologic abnormalities in a developing malignant condition?

AU - Northup, Jill K.

AU - Gadre, Swarupa A.

AU - Ge, Yimin

AU - Lockhart, Lillian

AU - Velagaleti, Gopalrao V N

PY - 2007/2

Y1 - 2007/2

N2 - Cytogenetic evaluation of bone marrow and neoplastic tissues plays a critical role in determining patient management and prognosis. Here, we highlight two cases in which the cytogenetic studies challenge the common practice of using hematologic and morphologic changes as key factors in malignant disease management. The first case is that of a lymph node sample from a 40-yr-old non-Hodgkin's lymphoma (NHL) patient sent for determination of disease progress. Hematologic studies showed no evidence of transformation to high-grade NHL (>15% blasts with rare mitotic figures). Cytogenetic studies of lymph node showed multiple clonal abnormalities, most notably a der(18) from a t(14;18) which is associated with high-grade NHL. After two cycles of chemotherapy with fludarabine, the patient did not show any clinical response, suggesting possible progression to high-grade lymphoma. The second case is of a patient with a history of human immunodeficiency virus and blastic natural killer leukemia/lymphoma. Hematologic studies of ascitic fluid classified the patient as having pleural effusion lymphoma whereas bone marrow analysis showed no malignancy. Bone marrow cytogenetic studies showed multiple clonal abnormalities including a t(8;14), which is commonly associated with Burkitt's lymphoma (BL). To our knowledge, this is the first case wherein a morphologically normal bone marrow showed presence of clonal abnormalities consistent with BL or Pleural effusion lymphoma. After two cycles of CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) chemotherapy, the patient's general condition and ascitis improved and she was discharged. These studies clearly demonstrate that genetic changes often precede morphologic changes in a developing malignant condition. Therefore, the critical information needed for care of patients with malignant disorders may be incomplete or inaccurate if cytogenetic evaluation is overlooked.

AB - Cytogenetic evaluation of bone marrow and neoplastic tissues plays a critical role in determining patient management and prognosis. Here, we highlight two cases in which the cytogenetic studies challenge the common practice of using hematologic and morphologic changes as key factors in malignant disease management. The first case is that of a lymph node sample from a 40-yr-old non-Hodgkin's lymphoma (NHL) patient sent for determination of disease progress. Hematologic studies showed no evidence of transformation to high-grade NHL (>15% blasts with rare mitotic figures). Cytogenetic studies of lymph node showed multiple clonal abnormalities, most notably a der(18) from a t(14;18) which is associated with high-grade NHL. After two cycles of chemotherapy with fludarabine, the patient did not show any clinical response, suggesting possible progression to high-grade lymphoma. The second case is of a patient with a history of human immunodeficiency virus and blastic natural killer leukemia/lymphoma. Hematologic studies of ascitic fluid classified the patient as having pleural effusion lymphoma whereas bone marrow analysis showed no malignancy. Bone marrow cytogenetic studies showed multiple clonal abnormalities including a t(8;14), which is commonly associated with Burkitt's lymphoma (BL). To our knowledge, this is the first case wherein a morphologically normal bone marrow showed presence of clonal abnormalities consistent with BL or Pleural effusion lymphoma. After two cycles of CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) chemotherapy, the patient's general condition and ascitis improved and she was discharged. These studies clearly demonstrate that genetic changes often precede morphologic changes in a developing malignant condition. Therefore, the critical information needed for care of patients with malignant disorders may be incomplete or inaccurate if cytogenetic evaluation is overlooked.

KW - Burkitt's lymphoma

KW - Clonal abnormalities

KW - Primary effusion lymphoma

KW - Transformation

KW - Translocation

UR - http://www.scopus.com/inward/record.url?scp=33846112695&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33846112695&partnerID=8YFLogxK

U2 - 10.1111/j.1600-0609.2006.00798.x

DO - 10.1111/j.1600-0609.2006.00798.x

M3 - Article

VL - 78

SP - 152

EP - 156

JO - European Journal of Haematology

JF - European Journal of Haematology

SN - 0902-4441

IS - 2

ER -