Myelodysplastic/myeloproliferative neoplasm with t(2;11)(p21;q23)del(5) (q22;q33) but without mixed-lineage leukemia (MLL) rearrangement

Introduction. Myelodysplastic/myeloproliferative neoplasms represent a group of rare hematologic malignancies with concomitant characteristics of two different disorders. There are cytopenias and cytoses with dysplastic morphology in the circulating blood and hyperplastic bone marrow, respectively....

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Main Authors: Čolović Nataša, Denčić-Fekete Marija, Stamatović Dragana, Leković Danijela, Gotić Mirjana
Format: Article
Language:English
Published: Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade 2021-01-01
Series:Vojnosanitetski Pregled
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Online Access:http://www.doiserbia.nb.rs/img/doi/0042-8450/2021/0042-84501900011C.pdf
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author Čolović Nataša
Denčić-Fekete Marija
Stamatović Dragana
Leković Danijela
Gotić Mirjana
author_facet Čolović Nataša
Denčić-Fekete Marija
Stamatović Dragana
Leković Danijela
Gotić Mirjana
author_sort Čolović Nataša
collection DOAJ
description Introduction. Myelodysplastic/myeloproliferative neoplasms represent a group of rare hematologic malignancies with concomitant characteristics of two different disorders. There are cytopenias and cytoses with dysplastic morphology in the circulating blood and hyperplastic bone marrow, respectively. Many cytogenetic and molecular features have been found in this rare entity, but t(2;11)(p21;q23)del(5) (q22;q33) has not been described so far. Case report. We present a patient with myelodysplastic syndrome, subtype refractory anemia without ringed sideroblasts, with unique translocation t(2;11)(p21;q23) associated with del(5)(q22;q33) in the karyotype. Fluorescence in situ hybridization analysis did not detect mixed-lineage leukemia (MLL) rearrangement, which can be found in other hematologic malignancies with this translocation. After a year on supportive treatment with packed red cells, thrombocytosis developed with a concurrent increase in white blood cells and the Janus kinase-2 gene mutation. This confirmed the presence of myelodysplastic/myeloproliferative neoplasms. Due to the high platelet count, the cerebrovascular insult has occurred. The patient was treated supportively and with lenalidomide. After introducing the lenalidomide steadily, the patientʼs condition improved, the peripheral blood count normalized, and he became transfusion independent. Conclusion. Patients with the cytogenetic finding of t(2;11)(p21;q23) associated with del(5)(q22;q33) but without MLL rearrangement and with Ja-nus kinase-2 gene mutation presence, respond to lenalidomide therapy and have relatively longer overall survival.
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spelling doaj-art-4c80ebe426ee4994bc3bceb41baf15d42025-08-20T01:56:46ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202021-01-0178225125410.2298/VSP190127011C0042-84501900011CMyelodysplastic/myeloproliferative neoplasm with t(2;11)(p21;q23)del(5) (q22;q33) but without mixed-lineage leukemia (MLL) rearrangementČolović Nataša0Denčić-Fekete Marija1Stamatović Dragana2Leković Danijela3https://orcid.org/0000-0002-6194-8298Gotić Mirjana4https://orcid.org/0000-0002-8590-0328Clinical Center of Serbia, Clinic for Hematology, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, SerbiaClinical Center of Serbia, Clinic for Hematology, Belgrade, SerbiaMilitary Medical Academy, Clinic for Hematology, Belgrade, Serbia + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaClinical Center of Serbia, Clinic for Hematology, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, SerbiaClinical Center of Serbia, Clinic for Hematology, Belgrade, Serbia + University of Belgrade, Faculty of Medicine, Belgrade, SerbiaIntroduction. Myelodysplastic/myeloproliferative neoplasms represent a group of rare hematologic malignancies with concomitant characteristics of two different disorders. There are cytopenias and cytoses with dysplastic morphology in the circulating blood and hyperplastic bone marrow, respectively. Many cytogenetic and molecular features have been found in this rare entity, but t(2;11)(p21;q23)del(5) (q22;q33) has not been described so far. Case report. We present a patient with myelodysplastic syndrome, subtype refractory anemia without ringed sideroblasts, with unique translocation t(2;11)(p21;q23) associated with del(5)(q22;q33) in the karyotype. Fluorescence in situ hybridization analysis did not detect mixed-lineage leukemia (MLL) rearrangement, which can be found in other hematologic malignancies with this translocation. After a year on supportive treatment with packed red cells, thrombocytosis developed with a concurrent increase in white blood cells and the Janus kinase-2 gene mutation. This confirmed the presence of myelodysplastic/myeloproliferative neoplasms. Due to the high platelet count, the cerebrovascular insult has occurred. The patient was treated supportively and with lenalidomide. After introducing the lenalidomide steadily, the patientʼs condition improved, the peripheral blood count normalized, and he became transfusion independent. Conclusion. Patients with the cytogenetic finding of t(2;11)(p21;q23) associated with del(5)(q22;q33) but without MLL rearrangement and with Ja-nus kinase-2 gene mutation presence, respond to lenalidomide therapy and have relatively longer overall survival.http://www.doiserbia.nb.rs/img/doi/0042-8450/2021/0042-84501900011C.pdfmyelodysplastic syndromethrombocytosismyeloproliferative disordersjanus kinase-2mutationantineoplastic agentslenalidomidetreatment outcome
spellingShingle Čolović Nataša
Denčić-Fekete Marija
Stamatović Dragana
Leković Danijela
Gotić Mirjana
Myelodysplastic/myeloproliferative neoplasm with t(2;11)(p21;q23)del(5) (q22;q33) but without mixed-lineage leukemia (MLL) rearrangement
Vojnosanitetski Pregled
myelodysplastic syndrome
thrombocytosis
myeloproliferative disorders
janus kinase-2
mutation
antineoplastic agents
lenalidomide
treatment outcome
title Myelodysplastic/myeloproliferative neoplasm with t(2;11)(p21;q23)del(5) (q22;q33) but without mixed-lineage leukemia (MLL) rearrangement
title_full Myelodysplastic/myeloproliferative neoplasm with t(2;11)(p21;q23)del(5) (q22;q33) but without mixed-lineage leukemia (MLL) rearrangement
title_fullStr Myelodysplastic/myeloproliferative neoplasm with t(2;11)(p21;q23)del(5) (q22;q33) but without mixed-lineage leukemia (MLL) rearrangement
title_full_unstemmed Myelodysplastic/myeloproliferative neoplasm with t(2;11)(p21;q23)del(5) (q22;q33) but without mixed-lineage leukemia (MLL) rearrangement
title_short Myelodysplastic/myeloproliferative neoplasm with t(2;11)(p21;q23)del(5) (q22;q33) but without mixed-lineage leukemia (MLL) rearrangement
title_sort myelodysplastic myeloproliferative neoplasm with t 2 11 p21 q23 del 5 q22 q33 but without mixed lineage leukemia mll rearrangement
topic myelodysplastic syndrome
thrombocytosis
myeloproliferative disorders
janus kinase-2
mutation
antineoplastic agents
lenalidomide
treatment outcome
url http://www.doiserbia.nb.rs/img/doi/0042-8450/2021/0042-84501900011C.pdf
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