Acute myeloid leukemia in Turkish children with Fanconi anemia. One center experience in the period between 1964-1995

Abstract

Objective: Fanconi’s anemia (FA) is an autosomal recessive disorder characterized by a progressive pancytopenia,variable congenital abnormalities and an increased risk for the development of acute myeloid leukemia (AML). The objective of this study is to evaluate AML in the patients with FA diagnosed and followed-up in the Department of Pediatric Hematology at Ankara University School of Medicine in the period between 1964-1995. Methods: A total of 39 patients within the age range 2-14 years (mean 8.2±3.16), 28 male and 11 female were diagnosed as FA on the basis of congenital abnormalities, pancytopenia, bone marrow aplasia and diepoxybutane induced chromosomal abnormalities that observed in all patients. The hereditary and familial basis of FA was apparent in this series. Results: Common abnormalities were growth retardation, café- au- lait spots, hyperpigmentation, microcephaly, finger and thumb deformities,mental retardation and hypogenitalismus. Four AML (10.2%) were observed in our series. Cytogenetic analysis of these cases revealed 46/ XX, dup(3)(q22;q26) t(7;17) (p11;p11) in one where it was unsuccessful in three. Two cases could not achieve remission and died. The other two achieved complete remission and remained in remission for 2 and 6 monthsConclusion: Acute myelomonocytic leukemia in three cases and acute monocytic leukemia in one patient were diagnosed in our series. The patients with FA should be followed with regard to AML and solid tumors. AML and solid tumors should be taken into the consideration as the first manifestation of FA.

Keywords

• Fanconi
• acute myeloid leukemia
• congenital abnormalities
• diepoxybutane