Balkan Journal of Medical Genetics

CYTOGENETIC AND MORPHOLOGICAL ANALYSIS OF DE NOVO ACUTE MYELOID LEUKEMIA IN ADULTS: A SINGLE CENTER STUDY IN JORDAN
Ayesh MH1, Khassawneh B, Matalkah I, Alawneh K, Jaradat S
*Corresponding Author: Dr. Mahmoud H. Ayesh (Haj Yousef), Department of Internal Medicine, King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, P.O. Box 3030 Irbid 22110, The Hashemite Kingdom of Jordan; Tel.: +962-2-7200-600, Ext. 40713; Fax: +962- 2-7095-123; E- Mail address: ayesh_mahmoud@yahoo.com
page: 5

MATERIALS AND METHODS

The study was conducted at the King Abdullah University Hospital (KAUH), Irbid, The Hashemite Kingdom of Jordan. The KAUH is a referral hospital that serves over 1.5 million people, representing 25% of the Jordanian population [10]. Medical records of adult patients diagnosed with de novo AML were reviewed from September 2002 to April 2010. Chromosomal analysis on bone marrow aspirate was performed on 35 patients. Their age ranged from 16 to 73 years and 65% were males. Patients who had secondary AML, a previous diagnosis of myelodysplastic syndrome, or less than 16 years old were excluded. The morphological diagnosis of AML was made by a consultant hematopathologist and were based on the French-American-British (FAB) World Health Organization (WHO) criteria [11,12]. The diagnosis of AML was determined by Wright-stained bone marrow smears. Immunophenotyping of the bone marrow aspirate was performed using a panel of monoclonal antibodies (acute lymphoid and myeloid leukemia), consisting of CD11, CD14, CD15, CD33 and CD34 (myeloid markers); CD2, CD3, CD4, CD5 and CD7 (T-cell linage markers); CD10, CD19, CD20 and CD22 (B-cell lineage markers); and cytoplasmic IgM, CD117 and TdT (pre-B-cell lineage markers). Bone marrow aspiration samples were cultured for 24 and 48 hours without a mitogen. Conventional GTG-banding techniques were used for metaphase chromosome banding [International System for Human Cytogenetic Nomenclature (ISCN 2005-2009)] [13,14]. Cytogenetic abnormalities were identifi ed, performed, and classifi ed according to the ISCN 2005-2009 [13,14]. Patients were identifi ed as having a normal karyotype only after 20 normal metaphases were analyzed. Determination of an abnormal clone required the presence of at least two metaphases with an identical structural rearrangement or an extra chromosome and/or three cells with a missing chromosome [11,13,14]. Because of the lack of facilities, we did not perform fl uorescent in situ hybridization. Cytogenetic abnormalities were classifi ed according to the type of abnormality, gain or loss of genetic material, and number of abnormalities (one, two, and three or more) [13,14]. This study was approved by the Institutional Review Board (IRB) committee of Jordan University Hospital and King Abdullah University Hospital, Irbid, The Hashemite Kingdom of Jordan. Statistical Analysis. An SAS version 6.2 was used for the data analysis. The chi-square test was performed, and the Yates correction was used where indicated. A p value of <0.05 was considered statistically signifi cant.

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