Woo Kwang-Sook, Kim Kyung-Eun, Kim Kyeong-Hee, Kim Sung-Hyun, Park Joo-In, Shaffer Lisa G, Han Jin-Yeong
Department of Laboratory Medicine, Dong-A University College of Medicine, 1,3-Ga, Dongdaesin-dong, Seo-gu, Busan, 602-715, Korea.
Cancer Genet Cytogenet. 2009 Oct 15;194(2):71-4. doi: 10.1016/j.cancergencyto.2009.04.017.
Acute myeloid leukemia (AML) cases with monosomy 7 (-7) and del(7q) comprise a heterogeneous subgroup. The association of losses in 7q with myeloid leukemia suggests that this region contains a tumor suppressor gene or genes whose loss of function contributes to leukemic transformation or tumor progression. The -7/del(7q) aberrations frequently coexist with complex karyotypes such as -5/del(5q) and trisomy 8. In the present case, we identified a rare abnormality involving deletion of both arms of chromosome 7 presenting with a marker chromosome-like appearance in an AML patient. Bone marrow aspiration and biopsy revealed acute myelomonocytic leukemia. Immunophenotyping study showed CD13, CD14, CD33, CD117, and myeloperoxidase positivities. Analysis of 20 metaphases indicated a diploid cell number with an unidentifiable tiny marker chromosome instead of one normal chromosome 7, described as 46,XY,-7,+mar[20]. Array comparative genomic hybridization test confirmed the chromosome 7 origin of the marker chromosome with deletions of 7p and 7q. The evaluation after remission induction treatment indicated morphological and cytogenetic remissions. There is evidence that the outcome is better when -7 or del(7q) occurs in patients with a simple karyotype, compared with a complex karyotype.
伴有7号染色体单体(-7)和7号染色体长臂缺失(del(7q))的急性髓系白血病(AML)病例构成了一个异质性亚组。7号染色体长臂缺失与髓系白血病的关联表明,该区域含有一个或多个肿瘤抑制基因,其功能丧失促成了白血病转化或肿瘤进展。-7/del(7q)异常常与复杂核型如-5/del(5q)和8号染色体三体共存。在本病例中,我们在一名AML患者中发现了一种罕见的异常,涉及7号染色体双臂缺失,呈现出标记染色体样外观。骨髓穿刺和活检显示为急性粒单核细胞白血病。免疫表型研究显示CD13、CD14、CD33、CD117和髓过氧化物酶呈阳性。对20个中期细胞的分析表明细胞数为二倍体,有一条无法识别的微小标记染色体,而非一条正常的7号染色体,描述为46,XY,-7,+mar[20]。阵列比较基因组杂交检测证实了标记染色体起源于7号染色体,伴有7p和7q缺失。缓解诱导治疗后的评估显示形态学和细胞遗传学缓解。有证据表明,与复杂核型患者相比,-7或del(7q)出现在核型简单的患者中时预后更好。