1 Cytogenetic Laboratory, Bone Marrow Transplantation Center (CEMO), National Cancer Institute (INCA), Rio de Janeiro, Brazil.
2 Outpatient Department, Bone Marrow Transplantation Center (CEMO), National Cancer Institute (INCA), Rio de Janeiro, RJ, Brazil.
3 Hematology Department, Antônio Pedro University Hospital (HUAP), RJ, Brazil.
4 Immunology Laboratory, Bone Marrow Transplantation Center (CEMO), National Cancer Institute (INCA), Rio de Janeiro, Brazil.
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|Figure 1. BM analysis in diagnosis: (A) Myeloid blast cells (arrows on rigth), neutrophils with pseudo Pelger Huët appearance, typical of MDS (arrows on left). (B) Dysmegakaryopoiesis, dysplastic megakaryocyte (arrow); (C) Dyserythropoiesis: binucleated eritroblast (arrow). Immunophenotyping of BM cells: (D) 7.7% of myeloid blasts (in red) located in the CD45 region of medium intensity and medium complexity; (E) Anomalous expression of the HLA-DR marker in part of the neutrophil population; (F) Abnormal double expression of CD38 and HLA-DR in part of neutrophils; (G) Loss of CD13 expression for monocytic population; (H) Loss of CD33 expression in part of the blasts. (I) Illustration shows the karyotype 46,XY,t(11;16)(q23;q24) by G-banding. (J) FISH analysis of metaphase cell showing the chromosomal rearrangement involving the KMT2A gene (11q23 region) and chromosome 16, demonstrated by a split signal in one allele of the MLL/KMT2A gene (separated red and green signals).
|Figure 2. Summary of the steps showing the evolution from MDS to AML.|
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