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Marked bone marrow basophilia in a child with acute myeloid leukemia with a cryptic t(8;21)(q22;q22) chromosomal translocation

Leukemia volume 15, pages 1799–1801 (2001)Cite this article

Primary malignant disorders of basophils, ie acute basophilic leukemia, are rare.1 However, basophilia may accompany other hematologic malignancies. Bone marrow and peripheral blood basophilia commonly accompanies chronic myelogenous leukemia (CML) and is an important diagnostic feature of this disease.2 In those patients who present with accelerated disease or in blast crisis, the presence of basophilia is useful in distinguishing an underlying CML from de novo acute myeloid leukemia (AML). Basophilia is uncommonly associated with acute leukemia. Increased numbers of basophils occur in some cases AML containing either the t(6;9)(p23;q34) or chromosome 12p abnormalities.3,4 In this report, we describe an unusual case of AML containing a cryptic t(8;21) involving the AML1 and ETO genes that was associated with marked bone marrow basophilia. To our knowledge, this represents the first reported association of marked basophilia with expression of the chimeric AML1-ETO protein.

The patient received induction chemotherapy consisting of cytarabine and cladribine for AML with rapid clearance of myeloblasts from her bone marrow. The degree of basophilia has decreased in the 5 months since the patient initially presented; however, it is still present. The patient's most recent bone marrow aspirate was consistent with morphologic remission, although it contained 5% basophils; RT-PCR analysis performed on the same specimen was weakly positive for AML1-ETO transcript (data not shown). Interestingly, the patient's dermatographia has resolved concurrent with the reduction in bone marrow basophilia.

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Acknowledgements

We would like to thank J Dalton, R Marion, T Motroni and A Washington for expert technical assistance. This work was supported in part by a National Institutes of Health Cancer Center CORE grant CA21765, and by the American Lebanese and Syrian Associated Charities (ALSAC) of St Jude Children's Research Hospital.

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  1. Department of Pathology, St Jude Children's Research Hospital, Memphis, TN, USA

    RB Lorsbach & S Mathew

  2. Department of Hematology/Oncology, St Jude Children's Research Hospital, Memphis, TN, USA

    R McNall

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Lorsbach, R., McNall, R. & Mathew, S. Marked bone marrow basophilia in a child with acute myeloid leukemia with a cryptic t(8;21)(q22;q22) chromosomal translocation. Leukemia 15, 1799–1801 (2001). https://doi.org/10.1038/sj.leu.2402263

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