Acute myeloid leukemia with ETV6::CHIC2 fusion gene: ‘Pitfalls’ in diagnosis

Bibliographic Details
Title: Acute myeloid leukemia with ETV6::CHIC2 fusion gene: ‘Pitfalls’ in diagnosis
Authors: Li Ma, Yun Yue, Xia Zhang, Zhongfeng Wu, Wei Wang, Weiguo Wang
Source: Hematology, Vol 29, Iss 1 (2024)
Publisher Information: Taylor & Francis Group, 2024.
Publication Year: 2024
Collection: LCC:Diseases of the blood and blood-forming organs
Subject Terms: Acute myeloid leukemia, ETV6::CHIC2, basophilia, flow cytometry, ETV6::PDGFRA, Next Generation Sequencing, immunophenotype, Diseases of the blood and blood-forming organs, RC633-647.5
More Details: Objectives Acute myeloid leukemia (AML) with ETV6::CHIC2 and basophilia is rare in hematologic malignancies with poor prognosis. Due to the small number of clinical cases, it is misdiagnosed and missed frequently, and it is necessary to explore laboratory detection for accurate diagnosis.Methods We report a case of AML with ETV6::CHIC2 and basophilia by morphological screening, immunotyping with precise gating, interpretation of FISH results, and RNA transcriptome sequencing, thus laying the accurate diagnosis for clinical treatment.Results We confirmed a rare case of AML with ETV6::CHIC2 rather than FIP1L1::PDGFRA by morphological analysis, correct immunophenotyping via precise gating, rejecting one-sided view of FISH positive result and targeted RNA sequencing. Precise analysis and more advanced means avoid misdiagnosis and missed frequently. After accurate diagnosis, venetoclax and decitabine therapy were given instead of imatinib; eventually, the patient achieved a relatively good effect.Discussion Immunophenotype analysis is necessary to detect the expression of CD7 when encountering pseudo-lymphocytes with multilineage dysplasia and basophilia. FISH and RT–PCR are still indispensable means of diagnosis of fusion genes in hematologic malignancies but can only detect a limited number of known partner genes and fusion genes with known break points. NGS can achieve sequence analysis indiscriminately and detect all fusion transcripts theoretically, greatly improving the detection range. NGS sequencing is required for t(4;12)(q11;p13) in AML that are not accompanied by eosinophilia.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 16078454
1607-8454
Relation: https://doaj.org/toc/1607-8454
DOI: 10.1080/16078454.2024.2381170
Access URL: https://doaj.org/article/39e8fbb0c1de44d58f2f15801c650ae1
Accession Number: edsdoj.39e8fbb0c1de44d58f2f15801c650ae1
Database: Directory of Open Access Journals
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More Details
ISSN:16078454
DOI:10.1080/16078454.2024.2381170
Published in:Hematology
Language:English