from Section 2 - Cell biology and pathobiology
Published online by Cambridge University Press: 05 April 2013
Introduction
Acute leukemia is best managed through the use of risk-adapted therapy. The karyotype of patients at diagnosis is an important factor in predicting response to therapy, and cytogenetic methods to detect the presence or absence of particular chromosomal abnormalities are key to stratifying patients by risk group. Identifying the genes involved in recurrent chromosomal abnormalities and understanding the roles of these genes in regulating cell growth and inducing malignant transformation can provide important insights into the altered biology of leukemic cells and help in devising novel risk-directed treatment strategies. This chapter reviews cytogenetic nomenclature and procedures as well as numeric and structural chromosomal abnormalities and their clinical associations, including prognosis, in acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Associations between specific cytogenetic and molecular changes, and their roles in diagnosis and risk assessment are also discussed.
Conventional cytogenetics
Standard chromosomal analysis remains the method of choice for initial screening of karyotypic abnormalities in leukemic cells. Conventional cytogenetic methods detect chromosomal abnormalities in clones of mitotically active (metaphase) neoplastic cells only and are particularly efficient in identifying abnormalities associated with acute leukemias. These methods can detect an abnormal clone in 90% of children and adolescents with ALL and 80% of those with AML. They also permit the study of complex cytogenetic changes in neoplastic cells, although complementary genetic methods such as reverse transcriptase polymerase chain reaction (RT-PCR) or fluorescence in situ hybridization (FISH) are needed to detect cryptic abnormalities or to evaluate equivocal results.
To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Find out more about the Kindle Personal Document Service.
To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.
To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.