Yanuck M D, Saleem A
Department of Pathology, Baylor College of Medicine, Houston, TX.
Ann Clin Lab Sci. 1991 May-Jun;21(3):171-6.
The literature was reviewed by us for leukemic transformation in the myelodysplastic syndrome (MDS). The factors reviewed included morphology, karyotype, in vitro cell culture, cellular oncogenes, genetic mutations and cell markers. Karyotypic abnormalities appeared to be most commonly associated with leukemic transformation in MDS. These abnormalities include: (1) Chromosomal abnormalities at the time of diagnosis; (2) multiple chromosomal abnormalities, especially in patients previously exposed to cytotoxic drugs, and (3) New chromosomal abnormalities following diagnosis. Leukemic transformation was also associated with non-random chromosomal abnormalities, abnormal localization of immature precursors (ALIP), dysgranulopoiesis and dysmegakaryocytopoiesis, in vitro cell cultures showing high cluster/colony ratio, and N-ras oncogene mutation and activation. However, karyotypic analysis at presentation and during the course of the disease appears to be the best predictor for leukemic transformation in patients with MDS.
我们查阅了关于骨髓增生异常综合征（MDS）白血病转化的文献。所查阅的因素包括形态学、核型、体外细胞培养、细胞癌基因、基因突变和细胞标志物。核型异常似乎最常与MDS的白血病转化相关。这些异常包括：（1）诊断时的染色体异常；（2）多个染色体异常，特别是在先前接触过细胞毒性药物的患者中；以及（3）诊断后的新染色体异常。白血病转化还与非随机染色体异常、未成熟前体细胞异常定位（ALIP）、粒系造血异常和巨核系造血异常、体外细胞培养显示高集落/集簇比值以及N-ras癌基因突变和激活有关。然而，疾病初发时及病程中的核型分析似乎是MDS患者白血病转化的最佳预测指标。
