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KaryoTrainer
LevelsAbout
فارسی
  1. 1Normal karyotype
  2. 2A single, simple abnormality — one deletion or one extra/missing chromosome
  3. 3Wider numerical abnormalities
  4. 4Structural abnormalities — common translocations and rearrangements
  5. 5Combined abnormalities (complex karyotypes)

Learn human karyotyping by playing

The curriculum — five stages

A path from the normal karyotype to complex ones. Each stage lists its playable levels first, then the reference cases from the atlas.

playable levels
3
reference cases
95
teaching stages
5
01

Stage 1

Normal karyotype

The starting point: learn the normal arrangement of 46 chromosomes in a male and a female before meeting any abnormality.

This stage has no playable level yet: no freely licensed, cuttable photograph was available for these abnormalities, and structural rearrangements cannot be shown by counting and placing chromosomes at all.

Reference cases (2)Show list

From the karyotype teaching atlas for haematopathology. Each case searches the Atlas of Genetics and Cytogenetics.

  • 46,XYSearch imagesNormal adult male karyotype — the reference point for every abnormal karyotype
  • 46,XXSearch imagesNormal adult female karyotype — the reference point for every abnormal karyotype
02

Stage 2

A single, simple abnormality — one deletion or one extra/missing chromosome

The simplest level of abnormality: a single numerical event (one trisomy or monosomy) or one deletion, with nothing else alongside it. Ordered from the most to the least common in blood neoplasms.

This stage has no playable level yet: no freely licensed, cuttable photograph was available for these abnormalities, and structural rearrangements cannot be shown by counting and placing chromosomes at all.

Reference cases (27)Show list

From the karyotype teaching atlas for haematopathology. Each case searches the Atlas of Genetics and Cytogenetics.

  • del(13q14)Search imagesCLL — the most common single abnormality in CLL (~55% of cases); favourable when it is the sole finding
  • +8(trisomy 8)Search imagesAML / MDS / MPN — the most common single trisomy in myeloid neoplasms
  • -Y(loss of Y)Search imagesAn age-related finding, sometimes alongside CLL — the most common single abnormality in older men
  • +12(trisomy 12)Search imagesCLL — intermediate prognosis (~16-20% of cases)
  • del(11q22-q23)ATMSearch imagesCLL — unfavourable prognosis
  • del(5q)5q- syndromeSearch imagesMDS with a favourable prognosis (older women, thrombocytosis)
  • del(17p13)TP53Search imagesCLL — very unfavourable prognosis
  • -7(monosomy 7)Search imagesMDS / AML — unfavourable prognosis
  • del(20q)Search imagesMDS — usually a relatively favourable prognosis
  • -5(monosomy 5)Search imagesMDS / AML — unfavourable prognosis
  • +21(trisomy 21)Search imagesALL in Down syndrome / transient neonatal AML
  • del(13q)Search imagesMultiple myeloma — a prognostic marker
  • del(17p)TP53Search imagesMultiple myeloma — high risk
  • -XSearch imagesMDS in older women
  • +4Search imagesALL with a good prognosis (a hyperdiploidy marker)
  • +10Search imagesALL with a good prognosis
  • +6Search imagesALL
  • +17Search imagesALL
  • +18Search imagesALL
  • +9Search imagesMPN
  • +19Search imagesAML
  • +11Search imagesAML
  • +13Search imagesAML
  • +3Search imagesMDS / AML
  • -18Search imagesMDS
  • -20Search imagesMDS
  • -21Search imagesMDS
03

Stage 3

Wider numerical abnormalities

More chromosomes gained or lost at once (hyperdiploidy/hypodiploidy), or a whole segment or arm of one chromosome gained or lost — the middle level of numerical complexity.

This stage has no playable level yet: no freely licensed, cuttable photograph was available for these abnormalities, and structural rearrangements cannot be shown by counting and placing chromosomes at all.

Reference cases (10)Show list

From the karyotype teaching atlas for haematopathology. Each case searches the Atlas of Genetics and Cytogenetics.

  • High hyperdiploidy (51-65 chromosomes)Search imagesB-ALL — favourable prognosis (~25% of childhood ALL, the most common numerical subgroup)
  • Hyperdiploid myeloma (trisomies of 3, 5, 7, 9, 11, 15, 19, 21)Search imagesMultiple myeloma — about half of all cases, with a relatively more favourable prognosis
  • 1q21gain (amp CKS1B)Search imagesMultiple myeloma — high risk
  • i(17q)Search imagesMDS / MPN — an isochromosome that loses the 17p arm and gains a second 17q arm
  • der(1;7)(q10;p10)Search imagesMDS — an unbalanced translocation losing part of chromosome 7
  • Low hypodiploidy (40-43 chromosomes)Search imagesALL
  • Hypodiploidy (33-39 chromosomes)Search imagesALL — unfavourable prognosis
  • iAMP21(intrachromosomal amplification of chromosome 21)Search imagesB-ALL — unfavourable prognosis; several extra copies of part of chromosome 21
  • Near-triploidy(66-80 chromosomes)Search imagesALL
  • Near-haploidy(23-29 chromosomes)Search imagesALL — very unfavourable prognosis, rare
04

Stage 4

Structural abnormalities — common translocations and rearrangements

A rearrangement between two chromosomes (or within one) that usually creates a specific fusion gene. Ordered from the most to the least common across blood malignancies.

This stage has no playable level yet: no freely licensed, cuttable photograph was available for these abnormalities, and structural rearrangements cannot be shown by counting and placing chromosomes at all.

Reference cases (36)Show list

From the karyotype teaching atlas for haematopathology. Each case searches the Atlas of Genetics and Cytogenetics.

  • t(9;22)(q34;q11)BCR::ABL1Search imagesCML — the Philadelphia chromosome; the defining abnormality, present in nearly 100% of CML
  • t(15;17)(q24;q21)PML::RARASearch imagesAcute promyelocytic leukaemia (APL) — the defining abnormality
  • t(8;21)(q22;q22)RUNX1::RUNX1T1Search imagesAML with maturation (M2) — one of the most common core-binding-factor AML translocations
  • inv(16)(p13.1q22)/ t(16;16) CBFB::MYH11Search imagesMyelomonocytic AML with eosinophilia (M4Eo)
  • t(11;14)(q13;q32)CCND1::IGHSearch imagesMantle cell lymphoma / multiple myeloma
  • t(14;18)(q32;q21)IGH::BCL2Search imagesFollicular lymphoma — the most common translocation in B-cell lymphoma
  • t(12;21)(p13;q22)ETV6::RUNX1Search imagesB-ALL — the most common translocation in childhood ALL (cryptic, needs FISH); favourable prognosis
  • t(9;22)(q34;q11)BCR::ABL1Search imagesPhiladelphia-positive ALL (Ph+ ALL) — high risk
  • t(8;14)(q24;q32)MYC::IGHSearch imagesBurkitt leukaemia / lymphoma
  • t(4;14)(p16;q32)FGFR3/NSD2::IGHSearch imagesMultiple myeloma — high risk
  • t(1;19)(q23;p13)TCF3::PBX1Search imagesPre-B B-ALL
  • t(4;11)(q21;q23)KMT2A::AFF1Search imagesInfant B-ALL — unfavourable prognosis
  • t(9;11)(p21;q23)KMT2A::MLLT3Search imagesMonocytic AML (M5)
  • t(3;14)(q27;q32)BCL6::IGHSearch imagesDiffuse large B-cell lymphoma (DLBCL)
  • t(14;16)(q32;q23)MAF::IGHSearch imagesMultiple myeloma — high risk
  • t(2;5)(p23;q35)NPM1::ALKSearch imagesAnaplastic large cell lymphoma (ALCL)
  • t(11;18)(q21;q21)BIRC3::MALT1Search imagesMALT lymphoma
  • t(6;9)(p23;q34)DEK::NUP214Search imagesAML with basophilia
  • inv(3)(q21q26.2)/ t(3;3)(q21;q26.2) GATA2::MECOMSearch imagesAML/MDS with thrombocytosis; poor prognosis
  • t(1;22)(p13;q13)RBM15::MKL1Search imagesMegakaryoblastic AML (M7) in infants
  • t(9;12)(p24;p13)ETV6::JAK2Search imagesMPN
  • t(5;12)(q32;p13)PDGFRB::ETV6Search imagesChronic eosinophilic leukaemia
  • t(8;9)(p22;p24)PCM1::JAK2Search imagesMPN / eosinophilic leukaemia
  • t(5;14)(q31;q32)IL3::IGHSearch imagesB-ALL with eosinophilia
  • t(3;21)(q26;q22)RUNX1::MECOMSearch imagesSecondary MDS / t-AML
  • t(1;3)(p36;q21)Search imagesMDS
  • t(2;8)(p12;q24)IGK::MYCSearch imagesBurkitt lymphoma (variant)
  • t(8;22)(q24;q11)MYC::IGLSearch imagesBurkitt lymphoma (variant)
  • t(1;14)(p22;q32)BCL10::IGHSearch imagesMALT lymphoma
  • t(9;14)(p13;q32)PAX5::IGHSearch imagesLymphoplasmacytic lymphoma
  • t(11;19)(q23;p13.3)KMT2A::MLLT1Search imagesInfant ALL/AML
  • t(9;12)(q34;p13)ETV6::ABL1Search imagesRare Ph-like ALL/AML
  • t(8;16)(p11;p13)KAT6A::CREBBPSearch imagesMonocytic AML with haemophagocytosis
  • t(6;11)(q27;q23)KMT2A::MLLT4Search imagesAML
  • t(10;11)(p12;q23)KMT2A::MLLT10Search imagesAML
  • t(1;11)(q21;q23)KMT2A::MLLT11Search imagesAML/ALL
05

Stage 5

Combined abnormalities (complex karyotypes)

The highest level of complexity: several numerical and structural abnormalities at once (three or more), usually with an unfavourable prognosis. Ordered from the best-known pattern to the rarest.

This stage has no playable level yet: no freely licensed, cuttable photograph was available for these abnormalities, and structural rearrangements cannot be shown by counting and placing chromosomes at all.

Reference cases (20)Show list

From the karyotype teaching atlas for haematopathology. Each case searches the Atlas of Genetics and Cytogenetics.

  • Complex karyotype AML (3 or more simultaneous abnormalities)Search imagesAML — very unfavourable prognosis
  • Complex karyotype MDSSearch imagesHigh-risk MDS
  • Monosomal karyotypeSearch imagesAML — the worst prognostic group (2+ monosomies, or 1 monosomy plus a structural abnormality)
  • Therapy-relatedAML with a complex karyotypeSearch imagesSecondary AML after chemotherapy
  • Complex karyotype with concurrent -5/-7Search imagesSecondary AML
  • Secondary MDS with concurrent -5, -7 and del(5q)Search imagesSecondary MDS after treatment
  • Double-hitlymphoma: t(8;14) + t(14;18)Search imagesHigh-risk DLBCL
  • Triple-hitlymphoma (MYC + BCL2 + BCL6)Search imagesVery high-risk DLBCL
  • Complex karyotype with multiple IGH rearrangementsSearch imagesHigh-risk multiple myeloma
  • Hyperdiploid myeloma with a concurrent structural abnormalitySearch imagesMultiple myeloma — prognosis varies with the accompanying structural abnormality
  • Double Ph + i(17q) + +8Search imagesCML — blast crisis
  • An extra Ph chromosome with i(17q) and +8 in blast crisisSearch imagesCML — blast crisis phase
  • Richter transformation with del(17p) and a complex karyotypeSearch imagesRichter transformation of CLL
  • Burkitt lymphoma with a complex karyotypeSearch imagesHigh-risk Burkitt lymphoma
  • Near-triploidB-ALL with a structural abnormalitySearch imagesHigh-risk B-ALL
  • Plasma cell leukaemia with a complex hyperdiploid-structural karyotypeSearch imagesPlasma cell leukaemia
  • Complex PML::RARA rearrangement (variant)Search imagesVariant APL
  • Mixed-phenotypeacute leukaemia (MPAL) with t(9;22) plus added abnormalitiesSearch imagesMPAL
  • CMML with a complex karyotypeSearch imagesChronic myelomonocytic leukaemia
  • Complex karyotype with a shattered genome (chromothripsis)Search imagesHigh-risk AML/MDS
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