J Med Cases

Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc

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Case Report

Volume 17, Number 6, June 2026, pages 263-270

Isolated Neutropenia as a Sentinel of High-Risk Clonal Evolution: Acute Myeloid Leukemia With Myelodysplasia-Related Changes Harboring TP53 Deletion via Isochromosome 17q and Deletion 20q Mimicking a Myeloproliferative Neoplasm

↓ **Table 1.** Diagnostic Criteria for AML-MRC
^aMyelodysplasia-related cytogenetic aberrations include: 1) complex karyotype (≥ 3 abnormalities); 2) unbalanced abnormalities: loss of chromosome 7 or del (7q), del(5q) or t(5q), isochromosome 17q or t(17p), loss of chromosome 13 or del(13q), del(11q), del(12p) or t(12p), idic(X)(q13); and 3) balanced abnormalities: t(11;16)(q23.3;p13.3), t(3;21)(q26.2;q22.1), t(1;3)(p36.3;q21.2), t(2;11)(p21;q23.3), t(5;12)(q32;p13.2), t(5;7)(q32;q11.2), t(5;17)(q32;p13.2), t(5;10)(q32;q21), t(3;5)(q25.3;q35.1). AML-MRC: acute myeloid leukemia with myelodysplasia-related changes; MDS: myelodysplastic syndrome; MPN: myeloproliferative neoplasia.
Diagnosis of AML -MRC according to the following 3 criteria:
≥ 20% bone marrow blasts
At least one of the following
Antecedent MDS-MPN
MDS-related cytogenetic aberration^a
Multilineage dysplasia ≥ 50%
Exclusion of the following:
Antecedent radiation of cytotoxic therapy
Recurrent cytogenetic aberration defining AML with recurrence cytogenetic aberrations

↓ Table 1. Diagnostic Criteria for AML-MRC

^aMyelodysplasia-related cytogenetic aberrations include: 1) complex karyotype (≥ 3 abnormalities); 2) unbalanced abnormalities: loss of chromosome 7 or del (7q), del(5q) or t(5q), isochromosome 17q or t(17p), loss of chromosome 13 or del(13q), del(11q), del(12p) or t(12p), idic(X)(q13); and 3) balanced abnormalities: t(11;16)(q23.3;p13.3), t(3;21)(q26.2;q22.1), t(1;3)(p36.3;q21.2), t(2;11)(p21;q23.3), t(5;12)(q32;p13.2), t(5;7)(q32;q11.2), t(5;17)(q32;p13.2), t(5;10)(q32;q21), t(3;5)(q25.3;q35.1). AML-MRC: acute myeloid leukemia with myelodysplasia-related changes; MDS: myelodysplastic syndrome; MPN: myeloproliferative neoplasia.

Diagnosis of AML -MRC according to the following 3 criteria:

≥ 20% bone marrow blasts

At least one of the following

Antecedent MDS-MPN

MDS-related cytogenetic aberration^a

Multilineage dysplasia ≥ 50%

Exclusion of the following:

Antecedent radiation of cytotoxic therapy

Recurrent cytogenetic aberration defining AML with recurrence cytogenetic aberrations