Myelodysplastic syndrome with t(6;9)(p22;q34.1)/DEK-NUP214 better classified as acute myeloid leukemia? A multicenter study of 107 cases

Hong Fang, Mariko Yabe, Xiaohui Zhang, Young Kim, Xiaojun Wu, Peng Wei, Sunyi Chi, Lan Zheng, Guillermo Garcia-Manero, Lina Shao, Ji Yuan, Yulei Shen, Gang Zheng, Guiling Tang, Wei Wang, Sanam Loghavi, Qi Shen, Yongzhong Yuan, Rong He, Dong ChenL. Jeffrey Medeiros, Shimin Hu

Research output: Contribution to journalArticlepeer-review


t(6;9)(p22;q34.1)/DEK-NUP214 is a recurrent genetic abnormality that occurs in 1–2% of patients with acute myeloid leukemia (AML), and rarely in myelodysplastic syndrome (MDS). It has been suggested by others that all myeloid neoplasms with t(6;9)/DEK-NUP214 may be considered as AML, even when blast count is <20%. In this study, we compared the clinicopathologic features of 107 patients with myeloid neoplasms harboring t(6;9)/DEK-NUP214: 33 MDS and 74 AML. Compared with patients with AML, patients with MDS were older (p = 0.10), had a lower white blood cell count (p = 0.0017), a lower blast count in the peripheral blood (p < 0.0001) and bone marrow (p < 0.0001), a higher platelet count (p = 0.022), and a lower frequency of FLT3-ITD mutation (p = 0.01). In addition, basophilia was not a common feature in the patients of this cohort. Although there was no difference in overall survival between MDS and AML patients (p = 0.18) in the entire cohort, the survival curves did show a trend toward favorable survival in MDS patients. Multivariate analyses showed that initial diagnosis of MDS vs. AML and allogeneic hematopoietic stem cell transplantation were prognostic factors for survival of patients with t(6;9)/DEK-NUP214 (p = 0.008 and p < 0.0001, respectively). Our data suggest that MDS with t(6;9)/DEK-NUP214 is prognostically not equivalent to AML with t(6;9)/DEK-NUP214. These data also show that stem cell transplantation greatly improves the survival of MDS and AML patients with myeloid neoplasms associated with t(6;9)/DEK-NUP214.

Original languageEnglish (US)
Pages (from-to)1143-1152
Number of pages10
JournalModern Pathology
Issue number6
StatePublished - Jun 2021

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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