A Deletion 7q in a M0 Adult Acute Myeloid Leukemia (AML) with a Complete Cytogenetic Response to Idarubicin.

The alteration of chromosome 7 is associated with a reported unfavorable prognosis in acute myeloid leukemia. The deletion of the 7q is seen alone in approximately 1% of AML cases. This finding is associated with an AML M0, M1, and M2 FAB classification. Treatment with idarubicin is thought to be equivalent to other anthracyclines in the induction of a complete remission in acute myeloid leukemia. In previous studies younger patients have responded with improved complete remission rates, when idarubicin is used. A unique case with a 7q single aberration and an AML M0 FAB classification is reported with a complete and rapid response of less than 32 days after one cycle of idarubicin at a dose of 12 mg /m²/day for three days accompanied by a cytosine arabinoside intravenous infusion at a dose of 100 mg/m²/day for seven days. A complete cytologic and genetic remission was obtained after one cycle of induction. The patient received high dose cytosine arabinoside consolidation and will be considered for autologous stem cell transplant. The patient remains in a complete genetic and cytologic remission. In this 25 year old african american female a complete cytologic and genetic remission by FISH is obtained in a rare acute myeloid leukemia genotype with a reportedly unfavorable prognosis using idarubicin as the anthracycline in the 3+7 combination.

Conclusion: Further studies are required to better define the appropriate anthracycline in acute myeloid leukemia by using age and cytogenetic markers. In this rare case presentation, idarubicin is shown to be effective in inducing a complete and rapid cytogenetic remission in a young adult patient with a chromosome 7 cytogenetic aberration and an unfavorable prognosis.