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Int J Clin Exp Pathol 2010;3(7):718-722

Case Report
Isolated trisomy 10 in an infant with acute myeloid leukemia: a case report and review of
literature

Ji Yuan, Colleen McDonough, Anita Kulharya, Preetha Ramalingam, Elizabeth Manaloor

Department of Pathology, Medical College of Georgia, Augusta, USA; Section of Hematology and Oncology, Department of Pediatrics, Medical
College of Georgia, Augusta, USA

Received July 17, 2010; accepted August 12, 2010; available online August 17, 2010

Abstract: Trisomy 10 as the sole cytogenetic abnormality in AML is rare, with an incidence rate of ≤ 0.5%. It tends to affect the elderly and is
extremely rare in pediatric patients. We describe a case of an 8-month-old Caucasian baby who presented with prominence of left eye and
fever without lymphadenopathy or hepatosplenomegaly. Bone survey showed diffuse periosteal reaction in the femur, pelvis, maxillary and
orbital bones (with fracture). CBC revealed normal white blood cell count, mild anemia and moderate thrombocytopenia. Bone marrow biopsy
showed increased myeloblasts with bilineage dysplasia and 3-4+ reticulin fibrosis. Flow cytometry revealed blasts positive for CD34, CD33,
and MPO and negative for CD7, CD13, and HLA-DR. Trisomy 10 was demonstrated by chromosome analysis and fluorescence in-situ
hybridization. The patient received induction chemotherapy and achieved complete clinical and hematologic remission at day 28. However, he
relapsed after three cycles of chemotherapy. Compared to the two other reported pediatric cases, our patient has some unique features such
as much younger age and additional findings such as bilineage dysplasia and bone marrow fibrosis. Both reported cases and our case were
classified as AML-M2 indicating that this may be a common subtype in pediatric patients. Bone involvement was present in our patient and one
other case and both had similar immunophenotype (CD33+, CD7-). These findings suggest that isolated trisomy 10 may be associated with
distinct clinicopathologic features in pediatric AML. Studies on additional patients are needed to establish this association. (IJCEP1007007).

Keywords: Trisomy 10, acute myeloid leukemia, infant, review, CD7, CD13, CD33, CD34

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Address all correspondence to:
Ji Yuan, MD, PhD
BA-1583, 1120 15th ST.
Department of Pathology
Medical College of Georgia
Augusta, GA 30912
Tel: 706-721-2771
Fax: 706-721-7781
E-mail:
jiyuan@mcg.edu