Burak DURMAZ, Yunus Kasım TERZİ, Şeref KÖMÜRCÜ, Deniz TORUN, Salih KOZAN, Şefik GÜRAN, Cengiz BEYAN, Muhterem BAHÇE

Prostat kanserinden uzun süre sonra gelişen kompleks karyotipik anormali ile seyreden akut myeloblastik lösemi olgusu

Löseminin bir türü olan akut myeloblastik lösemi (AML) myeloid seriye ait olgunlaşmamışhücrelerin kemik iliğinde, kanda, bazen diğer dokularda aşırı birikimi ile karakterize hematolojikkanserdir. Lösemik hücre farklanmasında kemik iliği ve periferik kan hücrelerinde klonalkromozomal anomaliler ortaya çıkmaktadır. Bu anomaliler olgu tanısı ve prognozunu göstermesiaçısından önemlidir. Yazımızda prostat kanseri nedeni ile 12 yıl önce cerrahi ve hormon tedavisialan ilk tanı evresinde kompleks karyotip anomaliler tesbit edilen bir AML olgusu sunulmaktadır.Tanımlanan kompleks karyotipik anomalilerin prognoz üzerindeki etkisi tartışılmaktadır. Periferikkan ve kemik iliği incelemesinde AML tanısı konan 70 yaşındaki erkek olgunun kemik iliğindenyapılan sitogenetik incelemede 49, XY, -1, -2, +4, +6, +8, +8, -12, -13, der (1), +2 mar [3], 50,XY, -2, +4, +6, +8, +8, -13, +2mar [2], 50, XY, -2, +4, +6, +8, +11?, -13, +2 mar [1] saptandı.Kompleks karyotipler genelde olgularda kötü prognoz belirtecidir. AML tanısı konulan olgu hertürlü destek tedavisine rağmen tanıdan iki gün sonra kaybedildi. Sonuç olarak, özellikle yaşlıAMLli hastalarda gerek tanı, gerekse prognozun belirlenebilmesi için genetik incelemelerinmutlaka yapılması gerekliliği göz önünde bulundurulmalıdır.

Acute myeloid leukemia case def ined with complex karyotypic abnormalities long time af ter prostate cancer

Acute myeloid leukemia (AML) is a type of leukemia which is characterized by the excessiveaccumulation of immature myeloid bone marrow precursor cells in the marrow itself, in peripheralblood and sometimes also in other tissues. During differentiation of leukemia cells, clonalchromosomal abnormalities emerge in bone marrow and in peripheral blood cells. Theseanomalies are important for the disease diagnosis and prognosis. Here, an AML case whounderwent surgery for prostate cancer 12 years ago and received hormonal therapy is presented.Complex karyotypic abnormalities were present in the initial diagnosis phase The correlationbetween complex karyotypes and the prognosis in this case was discussed. Our 70 year-old patientwas diagnosed as AML after peripheral blood and bone marrow analyses. His bone marrowcytogenetic analyses revealed 49, XY, -1, -2, +4, +6, +8, +8, -12, -13, der (1), +2 mar [3], 50, XY,-2, +4, +6, +8, +8, -13, +2mar [2], 50, XY, -2, +4, +6, +8, +11?, -13, +2 mar [1]. Complexkaryotypes generally represents poor prognosis in AML cases. The patient died in two days afterthe initial diagnosis, although AML treatment was applied. As a result genetic examination shouldalways be performed in elderly AML patients for both diagnosis and prediction of prognosis.

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