Karyotypically unrelated clones in acute leukemias and myelodysplastic syndromes

Karyotypically unrelated clones were observed in nine of 399 newly diagnosed acute leukemia or myelodysplastic syndrome (MDS) patients: two (3.0%) of 66 French-American-British classification (FAB)-M2 patients, five (12.5%) of 40 M5 patients, one (20%) of five chronic myelomonocytic leukemia (CMMoL), patients, one (12.5%) of eight refractory anemia with excess blasts in transformation (RAEBT) patients, and none (0%) of 177 acute lymphoblastic leukemia patients had such clones. Cytogenetically unrelated clones occurred more frequently in FAB-M5 than in the other subtypes of AL or MDS (p less than 0.01). Five (55%) of the nine patients had trisomy 8, two (22%) had partial deletion of the long arm of chromosome 5 and two had (22%) trisomy 11. Patients had short survival times (median 2 months, range 1-26 months) after detection of unrelated clones; eight of the nine failed to respond to chemotherapy. None of our patients had two phenotypically different leukemic cell populations or underwent phenotypic conversion of leukemic cells during the course of the disease. These findings suggest that the unrelated clones may have been derived from the common leukemic clone without microscopic chromosome changes, and that the different chromosome abnormalities of the unrelated clones may represent additional genetic changes in leukemogenesis.