诊断陷阱:JMML与KMT2A重排的青少年急性髓细胞白血病。

IF 0.7 Q4 HEMATOLOGY
Case Reports in Hematology Pub Date : 2024-09-06 eCollection Date: 2024-01-01 DOI:10.1155/2024/7151394
Liesbeth Vanheeswijck, Sanjay Tewari, Robin Dowse, Nicola Potter, Jelena Jovanovic, Caroline L Furness, Elsje Van Rijswijk
{"title":"诊断陷阱:JMML与KMT2A重排的青少年急性髓细胞白血病。","authors":"Liesbeth Vanheeswijck, Sanjay Tewari, Robin Dowse, Nicola Potter, Jelena Jovanovic, Caroline L Furness, Elsje Van Rijswijk","doi":"10.1155/2024/7151394","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Lysine methyltransferase 2A (<i>KMT2A</i>) rearrangements are commonly found in juvenile acute myeloid leukaemia (AML). Although distinct diseases, there is a known clinical overlap between <i>KMT2A</i>-rearranged AML and juvenile myelomonocytic leukaemia (JMML). Both occur in infancy or early childhood and present with abnormal monocytosis. <i>Case Report</i>. We report a case of a 20-month-old girl, who presented with lethargy, recurrent infections, bruising, and marked hepatosplenomegaly. JMML was suspected after initial work-up, revealing an abnormal monocytosis without blast excess on immunophenotyping. The additional cytogenetic and molecular diagnostics, revealing a <i>KMT2A</i> rearrangement, was decisive for the confirmation of AML.</p><p><strong>Conclusion: </strong>This case highlights the challenges of diagnosing <i>KMT2A</i>-rearranged monocytic AML and the importance of careful morphological assessment in partnership with cytogenetic and molecular diagnostics to distinguish between <i>KMT2A</i>-rearranged AML and JMML. Moreover, the emerging role of molecular monitoring in AML is highlighted.</p>","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":null,"pages":null},"PeriodicalIF":0.7000,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11398955/pdf/","citationCount":"0","resultStr":"{\"title\":\"Pitfalls in Diagnosis: JMML versus <i>KMT2A</i> Rearranged Juvenile AML.\",\"authors\":\"Liesbeth Vanheeswijck, Sanjay Tewari, Robin Dowse, Nicola Potter, Jelena Jovanovic, Caroline L Furness, Elsje Van Rijswijk\",\"doi\":\"10.1155/2024/7151394\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Lysine methyltransferase 2A (<i>KMT2A</i>) rearrangements are commonly found in juvenile acute myeloid leukaemia (AML). Although distinct diseases, there is a known clinical overlap between <i>KMT2A</i>-rearranged AML and juvenile myelomonocytic leukaemia (JMML). Both occur in infancy or early childhood and present with abnormal monocytosis. <i>Case Report</i>. We report a case of a 20-month-old girl, who presented with lethargy, recurrent infections, bruising, and marked hepatosplenomegaly. JMML was suspected after initial work-up, revealing an abnormal monocytosis without blast excess on immunophenotyping. The additional cytogenetic and molecular diagnostics, revealing a <i>KMT2A</i> rearrangement, was decisive for the confirmation of AML.</p><p><strong>Conclusion: </strong>This case highlights the challenges of diagnosing <i>KMT2A</i>-rearranged monocytic AML and the importance of careful morphological assessment in partnership with cytogenetic and molecular diagnostics to distinguish between <i>KMT2A</i>-rearranged AML and JMML. Moreover, the emerging role of molecular monitoring in AML is highlighted.</p>\",\"PeriodicalId\":46307,\"journal\":{\"name\":\"Case Reports in Hematology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.7000,\"publicationDate\":\"2024-09-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11398955/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Case Reports in Hematology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1155/2024/7151394\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Case Reports in Hematology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2024/7151394","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"HEMATOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

背景:赖氨酸甲基转移酶 2A(KMT2A)重排常见于幼年急性髓细胞白血病(AML)。尽管KMT2A重排的急性髓细胞白血病与幼年髓单核细胞白血病(JMML)是两种不同的疾病,但两者之间存在已知的临床重叠。这两种疾病都发生在婴儿期或儿童早期,表现为异常单核细胞增多。病例报告。我们报告了一例 20 个月大的女孩,她表现为嗜睡、反复感染、瘀伤和明显的肝脾肿大。经初步检查,免疫分型显示单核细胞异常,但无鼓泡过多,因此怀疑为 JMML。额外的细胞遗传学和分子诊断发现了KMT2A重排,这对确诊急性髓细胞白血病起了决定性作用:本病例凸显了诊断 KMT2A 重排单核细胞急性髓细胞性白血病的挑战,以及仔细的形态学评估与细胞遗传学和分子诊断相结合对区分 KMT2A 重排急性髓细胞性白血病和 JMML 的重要性。此外,还强调了分子监测在急性髓细胞性白血病中的新兴作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pitfalls in Diagnosis: JMML versus KMT2A Rearranged Juvenile AML.

Background: Lysine methyltransferase 2A (KMT2A) rearrangements are commonly found in juvenile acute myeloid leukaemia (AML). Although distinct diseases, there is a known clinical overlap between KMT2A-rearranged AML and juvenile myelomonocytic leukaemia (JMML). Both occur in infancy or early childhood and present with abnormal monocytosis. Case Report. We report a case of a 20-month-old girl, who presented with lethargy, recurrent infections, bruising, and marked hepatosplenomegaly. JMML was suspected after initial work-up, revealing an abnormal monocytosis without blast excess on immunophenotyping. The additional cytogenetic and molecular diagnostics, revealing a KMT2A rearrangement, was decisive for the confirmation of AML.

Conclusion: This case highlights the challenges of diagnosing KMT2A-rearranged monocytic AML and the importance of careful morphological assessment in partnership with cytogenetic and molecular diagnostics to distinguish between KMT2A-rearranged AML and JMML. Moreover, the emerging role of molecular monitoring in AML is highlighted.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
51
审稿时长
13 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信