Acute myelogenous leukemia with t(6;9)(p23;q34): Report of three patients

Acute myelogenous leukemia (AML) with the translocation t(6;9)(p23;q34) is a rare disease entity with a poor prognosis. We report three patients; two were diagnosed with AML of French-American-British (FAB) Cooperative Group type M2 and one with refractory anemia with an excess of blasts (RAEB) followed by AML type M2. The first patient, a 22-year-old man, achieved complete remission (CR) after three courses of chemotherapy. Two months after the CR was achieved, cytogenetic analysis showed t(6;9) in his morphologically normal bone marrow. After 5 months of remission, the AML relapsed and was resistant to further chemotherapy. The second patient, a 19-year-old man who had not achieved remission after two courses of chemotherapy, was treated with allogeneic bone marrow transplantation (BMT). The transplant resulted in CR and the disappearance of t(6;9). Seventeen months after the transplant, polymerase chain reaction analysis revealed molecular remission, confirmed by the absence of DEK-CAN mRNA. This patient has been in a leukemia-free state for more than 3 years. The third patient, a 54-year-old woman, was diagnosed with RAEB. AML developed 6 months later and she died 12 months after the diagnosis of RAEB. We suggest that BMT should be performed if a suitable donor can be found, otherwise the outcome is poor.