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
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DISCUSSION
This is the fi rst report on the cytogenetic abnormalities
of de novo AML in adult ethnic Arabs
in Jordan. The M5 anomaly was the most frequent
morphological subtype. Cytogenetic abnormalities
were common and observed in 65% of our
patients. The most frequent balanced translocation
was t(15;17) and trisomy 8 was the most
common numerical chromosomal abnormality.
The median age for our patients was 39 years,
which is similar to reports from other Arab populations
in the region [5,8,9]. The median age in studies from western populations is in the range of 58-
63 years, with the majority of patients being older
than 55 years [3,15,16]. In contrast, the median age
of patients at the time of diagnosis of AML tend to
be younger in developing countries [5,8,9,16-19].
The explanation for the difference between age at
diagnosis in patients from different geographical
regions is not clear. This may be explained by the
effect of ethnic, geographical and environmental
factors. Similar to other studies from western countries
and Arab populations there was a clear male
predominance [9,15].
In this study, M5 was the most frequent morphological
subtype (55%) followed by M3 (19%).
In Saudi Arabia, M4 was the most common subtype
(39%), in Oman it was M2 (35%) and in Kuwait it
was M3 (23%) [5,8,9].
Cytogenetic abnormalities were observed in
65% of our patients, comparable to other studies
from similar Arab populations (52-73%) [5,8,9],
and large studies from different parts of the world
(52-78%) [3,15,16]. In our study, t(15;17) was the
most frequently obsereverd balanced translocation.
This was similar to that found in Kuwat [8]. Whereas
in Saudi Arabia, t(8;21) was the most frequent balanced
translocation [5], and t(8;21) and t(15;17)
were the most frequent translocations in Oman [9].
The most frequent numerical abnormality in this
study was the gain of chromosome 8 (13%), which
is similar to that found in Saudi Arabia and Oman
[5,9]. The inv(16) inversion was seen in 13% of our patients, which is higher than reported in similar
ethnic groups [5,8,9]. The absence of the t(8;21)
translocation in our patients may be explained by
the low percentage (9%) of the M2 subtype obsereved
in this study. As with other reports, several unusual
abnormalities were seen in this study.
Compared to similar reports on ethnic Arabs
from the region, there were similarities and variations
of the age, gender, and morphologic subtype
and chromosomal abnormalities in ethnic Arabs in
Jordan with de novo AML. The observed similarities
could be explained by the common ethnic, environmental
and geographic factors. Further large and
crossborder studies are needed to elucidate the cytogenetic
pattern of this disease, and to better understand
the effects of ethnic and geographical factors
that may underlie the biological diversity of AML.
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