A single-center cytogenetic study of 629 Chinese
patients with de novo acute myeloid
leukemiadevidence of major ethnic differences
and a high prevalence of acute promyelocytic
leukemia in Chinese patients
Chi-Chiu So
a,
*
, Thomas S. Wan
a
, Jessica L. Chow
b
, Koon-Chun Hui
a
,
William W. Choi
a
, Clarence C. Lam
a
, Li-Chong Chan
a
a
Department of Pathology, Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China;
b
Department
of Epidemiology, School of Public Health, University of California, Los Angeles, CA, USA
Cytogenetic information is important in the diagnosis, classification, and prognostication of acute
myeloid leukemia (AML). Data obtained from multicenter treatment trials are well published. In this
study, we contribute cytogenetic data from a large series of 629 Chinese patients with de novo AML
that were karyotyped in a single laboratory. A higher prevalence of acute promyelocytic leukemia
was observed when compared with non-Chinese series. The difference was most prominent in the
younger age group. Abnormalities at chromosomal region 11q23 and inv(16) seemed uncommon.
These ethnic differences may indicate underlying genetic susceptibility to AML development and/or
environmental differences. More comprehensive data on AML in the elder population are needed to
assess the role of cytogenetics in predicting prognosis and guiding treatment in this large subgroup
of patients.
Keywords Acute myeloid leukemia, acute promyelocytic leukemia, Chinese, cytogenetics,
prevalence
ª 2011 Elsevier Inc. All rights reserved.
Cytogenetic information is important for the diagnosis and
prognostication of acute myeloid leukemia (AML) (1). Prev-
alence data on various karyotypic abnormalities in AML from
large multicenter clinical trials have been published (2e4).
Although patient sample sizes are generally large in these
cooperative trials, differences in inclusion and exclusion
criteria, variation in expertise in karyotypic analysis and
culturing techniques exist among different centers. Such
heterogeneity can affect data accuracy. In this regard, large
single-center studies with fairly homogeneous populations
provide useful information to complement multicenter
studies. They may reveal ethnic differences in the pattern of
cytogenetic abnormalities in AML, which can have important
epidemiological implications for disease etiology and health
care planning. There are relatively few data sets from single
centers in Asia even though Asia contains over 60% of the
world’s population.
We reviewed our karyotypic data from the last 20 years on
Chinese patients with de novo AML obtained in a single
center. The prevalence of the major cytogenetic groups was
documented. Important differences when compared to data
from non-Chinese patients are highlighted and discussed.
Patients and methods
Patient ascertainment
We retrieved the records of all patients in our hospital with
a diagnosis of AML from January 1989 to June 2009, and we
reviewed their karyotypes from the cytogenetic database of
the Haematology Division, Department of Pathology, Queen
Mary Hospital. Secondary AML after documented myelo-
dysplastic syndrome, myeloproliferative neoplasm, or prior
Received March 22, 2011; received in revised form June 1, 2011;
accepted June 6, 2011.
* Corresponding author.
E-mail address: scc@pathology.hku.hk
2210-7762/$ - see front matter ª 2011 Elsevier Inc. All rights reserved.
doi:10.1016/j.cancergen.2011.06.003
Cancer Genetics 204 (2011) 430e438