Yan Zhen, Yang Bo, Wang Quan-Shun, Wang Li-Li, Han Xiao-Ping, Ren Fang, Yu Li
Department of Hematology, Chinese PLA General Hospital, Beijing 100853, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2010 Oct;18(5):1321-6.
This study was aimed to investigate the clinico-pathological features, diagnosis and treatment of the 8p11 (eight p11) myeloproliferative syndrome (EMS). Morphological changes of cells were evaluated by bone marrow smear and biopsy. The cell immunophenotypes were analysed by flow cytometry. Karyotypes were determined by conventional cytogenetic method, and bcr/abl fusion gene was detected by reverse transcription-polymerase chain reaction (RT-PCR). The results indicated that EMS was a relatively rare disease characterized by the occurrence of a bcr/abl-negative myeloproliferative disorder and a T-cell lymphoblastic lymphoma (T-LBL). Bone marrow examination showed myeloid hyperplasia or myeloproliferative neoplasm, often accompanied by eosinophilia. Flow cytometric immunophenotyping showed increased myelomonoblasts; cytogenetic analysis showed a translocation at the 8p11 locus; RT-PCR demonstrated non bcr/abl fusion gene. At the molecular level, all cases carried a chromosomal abnormality involving the fibroblast growth factor receptor 1 (FGFR1) at chromosome 8p11. Up to now, 11 partner genes have been identified and associated with FGFR1 rearrangements. The most common partner is ZNF198 on chromosome 13q11-12. Majority of patients terminate in acute myeloid leukemia which is resistant to conventional chemotherapy. Currently, the only curative option appears to be allogeneic hematopoietic stem cell transplantation. In conclusion, EMS is myeloid and lymphoid neoplasm, associates with FGFR1 rearrangements. It is usually misdiagnosed as T-LBL, atypical chronic myeloid leukemia (aCML) or chronic myelogenous-monocytic leukemia (CMML). Timely cytogenetic and molecular biological examination is vital in order to avoid misdiagnosis and mistreatment.
本研究旨在探讨8p11(8号染色体短臂11区)骨髓增殖综合征(EMS)的临床病理特征、诊断及治疗。通过骨髓涂片和活检评估细胞的形态学变化。采用流式细胞术分析细胞免疫表型。用常规细胞遗传学方法确定核型,通过逆转录聚合酶链反应(RT-PCR)检测bcr/abl融合基因。结果表明,EMS是一种相对罕见的疾病,其特征为发生bcr/abl阴性的骨髓增殖性疾病和T细胞淋巴母细胞淋巴瘤(T-LBL)。骨髓检查显示髓系增生或骨髓增殖性肿瘤,常伴有嗜酸性粒细胞增多。流式细胞术免疫表型分析显示髓单核细胞增多;细胞遗传学分析显示8p11位点有易位;RT-PCR证实无bcr/abl融合基因。在分子水平上,所有病例均存在涉及8号染色体p11区成纤维细胞生长因子受体1(FGFR1)的染色体异常。到目前为止,已鉴定出11个伙伴基因并与FGFR1重排相关。最常见的伙伴是位于13q11-12染色体上的ZNF198。大多数患者最终发展为对传统化疗耐药的急性髓系白血病。目前,唯一的治愈选择似乎是异基因造血干细胞移植。总之,EMS是一种髓系和淋巴系肿瘤,与FGFR1重排有关。它通常被误诊为T-LBL、非典型慢性髓系白血病(aCML)或慢性粒单核细胞白血病(CMML)。为避免误诊和误治,及时进行细胞遗传学和分子生物学检查至关重要。