• Share
  • Email
  • Embed
  • Like
  • Save
  • Private Content
Cytogenetic analysis in Hematological Malignancies
 

Cytogenetic analysis in Hematological Malignancies

on

  • 607 views

 

Statistics

Views

Total Views
607
Views on SlideShare
607
Embed Views
0

Actions

Likes
0
Downloads
7
Comments
0

0 Embeds 0

No embeds

Accessibility

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

    Cytogenetic analysis in Hematological Malignancies Cytogenetic analysis in Hematological Malignancies Presentation Transcript

    • Cytogenetic Analysis in Hematological Malignancies Hwei-Fang Tien, National Taiwan University Hospital
    • Recurrent chromosomal abnormalities in Hematological malignancies Abnormalities important for classification CML t(9;22) AML t(8;21), t(15;17), inv(16), t(9;11), inv(3), t(6;9), t(1;22), -5/5q-, -7/7q- ALL t(4;11), t(1;19), t(v;11q23), t(12;21)* MDS -Y, del(11q); del(5q), del(12p), del(20q); del(7q), +8, +19, i(17q); -7, inv(3) Lymphoma DLBCL t(3q27) Burkitt t(8;14) and variant Follicular t(14;18) Mantle cell t(11;14) Marginal zone t(11;18), t(1;14), t(14;18)
    • Purpose of Cytogenetic Study in Hematological malignancies 1. Diagnosis and classification 2. Risk stratification 3. Selection of proper treatment 4. Follow-up of the response
    • Case Demonstration Diagnosis
    • BM smears in a patient with thrombocytopenia and anemia NTUH, Gene Chromosome Cancer, 1995,12:161
    • Cytogenetic Abnormalities NTUH, Gene Chromosome Cancer, 1995,12:161 Final dignosis: hepatosplenic Tγ/δ lymphoma
    • Large granular lymphocytosis Br J Haematol, 1998, 103:1124 Cytogenetic Abnormalities Diagnosis: NK-cell large granular lymphocyte leukemia PB smears
    • BM aspirate smears from a patient with pancytopenia
    • Hypoplastic MDS
    • Name: 林X榮, 46, XY, -7 [20] Chromosomal abnormality Diagnosis: hypoplastic MDS Leukemia, 2008, 22:544
    • Case Demonstration For Lymphoma Staging
    • BM study for staging in a patients with DLBCL BM biopsy: no lymphoma involvement BM smears
    • Same Clonal Chromosomal Abnormalities in Lymph Node as in Bone Marrow Lymph node Bone marrow Lymphoma involvement of BM is confirmed
    • Risk Stratification
    • Impact of Cytogenetics in AML based on 2008 WHO Classification Medical Research Council , United Kingdom Blood. 2010;116(3):354 , Blood Rev, 2011; 25:39 t(9;22) -7/7q- -5/5q- Inv(3), t(3;3) t(9;11) t(3;5) t(6;9) MDS-related other t(11q23) t(15;17) t(8;21) Inv(16) 5876 patients Normal
    • Cytogenetic Scoring System in MDS (n=2,754) Abnormality Overall survival AML transformation Prognostic Subgroup No. of Pts % Single Double Cplx Median (months) Median (months) Very good 81 2.9 del(11q), -Y ― ― 60.8 NR Good (reference) 1,809 65.7 Normal, del(5q) del(12p), del(20q) Including del(5q) ― 48.6 NR Intermediate 529 19.2 del(7q), +8, i(17q) +19, any other Independent clones Any other ― 26.0 78.0 Poor 148 5.4 Inv(3)/t(3q)/del(3q), -7 Including -7/del(7q) 3 15.8 21.0 Very poor 187 6.8 ― ― > 3 5.9 8.2 Abbreviations: AML, acute myeloid leukemia; NR, not reached. Schanz et al, J Clin Oncol, 2012
    • MM: Impact of genomic aberrations on OS Blood. 2007;109:3489
    • Prognostic relevance of chromosome aberrations in CLL Best Pract Res Clin Haematol. 2007 20:439 17p- 11q- +12 13q- sole normal
    • Follow Up the Clinical Course
    • Chronic Myeloid Leukemia, Chronic Phase
    • CML in acute transformation
    • Indication of Cytogenetic Study • Unknown cause of cytopenia • Fever of unknown origin • WHO classification of AML and ALL • MDS diagnosis, classification (IPSS, IPSS-R) • Lymphoma diagnosis, classification and staging work up • Risk stratification of CLL and MM • Follow-up of treatment response
    • 台灣藍鵲( Formosan Blue Magpie )