{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T03:24:44Z","timestamp":1780629884116,"version":"3.54.1"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Hematol Oncol"],"published-print":{"date-parts":[[2010,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>The ring chromosome is a circular, structural abnormality composed of either multiple chromosomes or a single chromosome with loss of genetic material at one or both ends. This chromosomal rearrangement is often unstable with frequent recombinations and may be accompanied by either loss or amplification of genetic material[1]. Considering that ring chromosomes are rare in acute myelogenous leukemia (AML), it is difficult to risk stratify patient prognosis, particularly when the ring chromosome occurs as the sole abnormality. Here we report a case of a ring chromosome 18 abnormality in a patient with newly diagnosed AML with monocytic differentiation. Cytogenetic analysis demonstrated 46, XY, r(18)(p11q21) karyotype in 19 of 34 evaluated metaphase cells. The patient received induction chemotherapy and subsequent allogeneic cord blood transplant from a sex-matched donor, and remained in hematologic and cytogenetic remission for 120 days post transplant. Soon after, he developed post transplant lymphoproliferative disorder and died of multi-organ failure. Although r(18) chromosomal abnormalities were not classified in the recent updated evidence-and expert opinion-based recommendations for the diagnosis and management of AML (likely due to the small number of reported cases), the patient was treated as high risk with stem cell transplantation. This was based on the unstable nature of the ring chromosome and the poor outcomes described in the literature of patients with sole ring 18 abnormalities.<\/jats:p>","DOI":"10.1186\/1756-8722-3-25","type":"journal-article","created":{"date-parts":[[2010,7,22]],"date-time":"2010-07-22T18:17:09Z","timestamp":1279822629000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Ring chromosome 18 abnormality in acute myelogenous leukemia: the clinical dilemma"],"prefix":"10.1186","volume":"3","author":[{"given":"Shanthi","family":"Sivendran","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Gruenstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana K","family":"Malone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vesna","family":"Najfeld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2010,7,22]]},"reference":[{"issue":"3-4","key":"109_CR1","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1159\/000138881","volume":"121","author":"E Gebhart","year":"2008","unstructured":"Gebhart E: Ring chromosomes in human neoplasias. Cytogenet Genome Res. 2008, 121 (3-4): 149-73. 10.1159\/000138881.","journal-title":"Cytogenet Genome Res"},{"key":"109_CR2","first-page":"169","volume-title":"Hematology Am Soc Hematol Educ Program","author":"K Mrozek","year":"2006","unstructured":"Mrozek K, Bloomfield CD: Chromosome aberrations, gene mutations and expression changes, and prognosis in adult acute myeloid leukemia. Hematology Am Soc Hematol Educ Program. 2006, 169-77."},{"issue":"3","key":"109_CR3","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1182\/blood-2009-07-235358","volume":"115","author":"H Dohner","year":"2010","unstructured":"Dohner H: Diagnosis and management of acute myeloid leukemia in adults: recommendations from an international expert panel, on behalf of the European LeukemiaNet. Blood. 2010, 115 (3): 453-74. 10.1182\/blood-2009-07-235358.","journal-title":"Blood"},{"issue":"5","key":"109_CR4","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.1182\/blood.V70.5.1400.1400","volume":"70","author":"EJ Lee","year":"1987","unstructured":"Lee EJ: Minimally differentiated acute nonlymphocytic leukemia: a distinct entity. Blood. 1987, 70 (5): 1400-6.","journal-title":"Blood"},{"issue":"1","key":"109_CR5","first-page":"430","volume":"45","author":"JR Testa","year":"1985","unstructured":"Testa JR: Chromosomal alterations in acute leukemia patients studied with improved culture methods. Cancer Res. 1985, 45 (1): 430-4.","journal-title":"Cancer Res"},{"issue":"1","key":"109_CR6","doi-asserted-by":"crossref","first-page":"42","DOI":"10.5858\/2003-127-42-FCAOA","volume":"127","author":"Z Kaleem","year":"2003","unstructured":"Kaleem Z: Flow cytometric analysis of acute leukemias. Diagnostic utility and critical analysis of data. Arch Pathol Lab Med. 2003, 127 (1): 42-8.","journal-title":"Arch Pathol Lab Med"},{"issue":"13","key":"109_CR7","doi-asserted-by":"publisher","first-page":"4325","DOI":"10.1182\/blood-2002-03-0772","volume":"100","author":"JC Byrd","year":"2002","unstructured":"Byrd JC: Pretreatment cytogenetic abnormalities are predictive of induction success, cumulative incidence of relapse, and overall survival in adult patients with de novo acute myeloid leukemia: results from Cancer and Leukemia Group B (CALGB 8461). Blood. 2002, 100 (13): 4325-36. 10.1182\/blood-2002-03-0772.","journal-title":"Blood"},{"issue":"13","key":"109_CR8","doi-asserted-by":"crossref","first-page":"4075","DOI":"10.1182\/blood.V96.13.4075","volume":"96","author":"ML Slovak","year":"2000","unstructured":"Slovak ML: Karyotypic analysis predicts outcome of preremission and postremission therapy in adult acute myeloid leukemia: a Southwest Oncology Group\/Eastern Cooperative Oncology Group Study. Blood. 2000, 96 (13): 4075-83.","journal-title":"Blood"},{"issue":"7","key":"109_CR9","doi-asserted-by":"crossref","first-page":"2322","DOI":"10.1182\/blood.V92.7.2322","volume":"92","author":"D Grimwade","year":"1998","unstructured":"Grimwade D: The importance of diagnostic cytogenetics on outcome in AML: analysis of 1,612 patients entered into the MRC AML 10 trial. The Medical Research Council Adult and Children's Leukaemia Working Parties. Blood. 1998, 92 (7): 2322-33.","journal-title":"Blood"},{"issue":"1","key":"109_CR10","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/S0165-4608(98)00133-2","volume":"109","author":"K Michalova","year":"1999","unstructured":"Michalova K: Double minute chromosomes in a patient with myelodysplastic syndrome transforming into acute myeloid leukemia. Cancer Genet Cytogenet. 1999, 109 (1): 76-8. 10.1016\/S0165-4608(98)00133-2.","journal-title":"Cancer Genet Cytogenet"},{"issue":"1","key":"109_CR11","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/0165-4608(94)00284-I","volume":"82","author":"JR Sawyer","year":"1995","unstructured":"Sawyer JR: Cytogenetic findings in 200 patients with multiple myeloma. Cancer Genet Cytogenet. 1995, 82 (1): 41-9. 10.1016\/0165-4608(94)00284-I.","journal-title":"Cancer Genet Cytogenet"},{"issue":"4","key":"109_CR12","doi-asserted-by":"publisher","first-page":"315","DOI":"10.1007\/s004390050960","volume":"104","author":"D Gisselsson","year":"1999","unstructured":"Gisselsson D: The structure and dynamics of ring chromosomes in human neoplastic and non-neoplastic cells. Hum Genet. 1999, 104 (4): 315-25. 10.1007\/s004390050960.","journal-title":"Hum Genet"},{"issue":"1","key":"109_CR13","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/0165-4608(83)90064-X","volume":"8","author":"PH Fitzgerald","year":"1983","unstructured":"Fitzgerald PH: Nonrandom cytogenetic changes in New Zealand patients with acute myeloid leukemia. Cancer Genet Cytogenet. 1983, 8 (1): 51-66. 10.1016\/0165-4608(83)90064-X.","journal-title":"Cancer Genet Cytogenet"},{"issue":"2","key":"109_CR14","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1002\/gcc.10027","volume":"34","author":"K Mrozek","year":"2002","unstructured":"Mrozek K: Spectral karyotyping in patients with acute myeloid leukemia and a complex karyotype shows hidden aberrations, including recurrent overrepresentation of 21q, 11q, and 22q. Genes Chromosomes Cancer. 2002, 34 (2): 137-53. 10.1002\/gcc.10027.","journal-title":"Genes Chromosomes Cancer"},{"key":"109_CR15","doi-asserted-by":"crossref","unstructured":"Cytogenetics of acutely transformed chronic myeloproliferative syndromes without a Philadelphia chromosome. A multicenter study of 55 patients. Groupe Francais de Cytogenetique Hematologique. Cancer Genet Cytogenet. 1988, 32 (2): 157-68. 10.1016\/0165-4608(88)90278-6.","DOI":"10.1016\/0165-4608(88)90278-6"},{"issue":"1","key":"109_CR16","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1002\/gcc.10088","volume":"35","author":"C Schoch","year":"2002","unstructured":"Schoch C: Loss of genetic material is more common than gain in acute myeloid leukemia with complex aberrant karyotype: a detailed analysis of 125 cases using conventional chromosome analysis and fluorescence in situ hybridization including 24-color FISH. Genes Chromosomes Cancer. 2002, 35 (1): 20-9. 10.1002\/gcc.10088.","journal-title":"Genes Chromosomes Cancer"},{"issue":"4","key":"109_CR17","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1002\/gcc.2870100404","volume":"10","author":"B Gibbons","year":"1994","unstructured":"Gibbons B: Fluorescence in situ hybridisation studies to characterise complete and partial monosomy 7 in myeloid disorders. Genes Chromosomes Cancer. 1994, 10 (4): 244-9. 10.1002\/gcc.2870100404.","journal-title":"Genes Chromosomes Cancer"}],"container-title":["Journal of Hematology &amp; Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1756-8722-3-25.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T11:40:02Z","timestamp":1630496402000},"score":1,"resource":{"primary":{"URL":"https:\/\/jhoonline.biomedcentral.com\/articles\/10.1186\/1756-8722-3-25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,7,22]]},"references-count":17,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2010,12]]}},"alternative-id":["109"],"URL":"https:\/\/doi.org\/10.1186\/1756-8722-3-25","relation":{},"ISSN":["1756-8722"],"issn-type":[{"value":"1756-8722","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,7,22]]},"assertion":[{"value":"7 June 2010","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 July 2010","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 July 2010","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"25"}}