Isolated +15 in bone marrow: disease-associated or a benign finding?

Area of Science:

• Hematology
• Cytogenetics
• Oncology

Background:

• The clinical significance of isolated trisomy 15 ( +15) in bone marrow (BM) remains controversial.
• Determining whether +15 is disease-associated or a benign finding is crucial for patient management.

Purpose of the Study:

• To investigate the association of isolated trisomy 15 in bone marrow with hematologic malignancies.
• To differentiate between disease-associated and benign trisomy 15 findings in BM.

Main Methods:

• Retrospective review of cytogenetic archives.
• Analysis of 31 patients with isolated trisomy 15 in bone marrow.
• Correlation of +15 clonal size with disease status and blast burden.

Main Results:

• Four patients presented with acute myeloid leukemia (AML), where +15 was the major clone and correlated with disease status.
• Twenty-seven patients had +15 as a minor clone; 18 had prior cytotoxic therapy, 6 had lymphoma/myeloma.
• +15 was detected in myeloid/erythroid cells, not lymphoid cells, in patients with lymphoma/myeloma.
• None of the 27 patients without AML showed evidence of myelodysplastic syndromes during follow-up.

Conclusions:

• Isolated trisomy 15 can be associated with AML, particularly when it is a major clone.
• More frequently, isolated +15 in BM represents a minor clone and may not be disease-associated.
• Clinical follow-up is appropriate for non-leukemic patients with isolated +15, avoiding immediate therapeutic intervention.