A novel four-way variant of t(8;21) in a patient with acute myeloid leukaemia

Abstract

Acute myeloid leukaemia (AML) with t(8;21) is a common AML subtype and it is associated with a favourable prognosis. Variants of this translocation, involving other chromosomes in addition to chromosomes 8 and 21, account for an estimated 3–4% of AMLs with t(8;21). The clinicopathological characteristics of AML with variant t(8;21) are not as well defined as those of AML with classical t(8;21) owing to the rare occurrence. We report a case of an elderly patient who was diagnosed as having AML with maturation on morphology and was confirmed on cytogenetics and fluorescence in situ hybridisation (FISH) to have a complex t(8;21) involving two other chromosomes, namely t(21;8;7;10). The additional partner chromosomes in this patient have not been described in the few four-way translocation cases reported in literature. There was also a loss of Y chromosome observed, which is a common finding in AML with t(8;21). The patient demised less than a month after diagnosis. The prognostic significance of the variant translocations is still unclear, however, it is possible that the additional cytogenetic abnormalities may invalidate the favourable prognosis conferred by the classical t(8;21).