A young adult with acute myeloid leukaemia has blasts showing perinuclear clearing and salmon-coloured granules on smear, with maturation to abnormal eosinophils in the marrow. Which cytogenetic finding carries the most favourable prognostic implication in this patient?

• A Complex karyotype with three or more abnormalities
• B Monosomy 7
• C FLT3 internal tandem duplication
• D inv(16)(p13;q22) or t(16;16) ✓

Explanation

Abnormal marrow eosinophils indicate AML-M4eo, defined by inv(16) or t(16;16) disrupting CBFB, one half of the core binding factor. Together with t(8;21) (RUNX1-RUNX1T1), these constitute the favourable-risk cytogenetic group in AML with superior complete remission rates. Monosomy 7, FLT3-ITD and complex karyotype are all adverse-risk lesions associated with poor outcomes and higher relapse rates.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.