USMLE (United States Medical Licensing Examination) Step 1 Practice Exam

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What is the consequence of t(15;17) translocation in acute myeloid leukemia?

Decreased RBC, WBC, and Platelets
Increased eosinophils and lymphocytes
Increased risk of polycythemia vera
Increased abnormal pro-myelocytes and blasts, leading to DIC

The correct answer is: Increased abnormal pro-myelocytes and blasts, leading to DIC

The t(15;17) translocation is specifically associated with acute promyelocytic leukemia (APL), a subtype of acute myeloid leukemia (AML). This chromosomal rearrangement results in the fusion of the promyelocytic leukemia (PML) gene on chromosome 15 with the retinoic acid receptor-alpha (RARA) gene on chromosome 17. This fusion protein disrupts normal myeloid differentiation and causes the accumulation of abnormal promyelocytes, characterized by heavy granulation. As these abnormal promyelocytes and blasts proliferate, they can lead to a condition known as disseminated intravascular coagulation (DIC). This is due to the release of pro-coagulant factors, which is a critical clinical feature associated with APL. The presence of DIC can lead to severe bleeding complications, making this specific outcome highly relevant to the pathophysiology of t(15;17) translocation in this form of leukemia. Thus, the consequence of the t(15;17) translocation is closely linked to the increase of these abnormal cells alongside the risk for DIC, confirming the chosen answer as correct.