Karimata Kaori, Masuko Masayoshi, Ushiki Takashi, Kozakai Takashi, Shibasaki Yasuhiko, Yano Toshio, Abe Takashi, Moriyama Masato, Toba Ken, Furukawa Tatsuo, Aizawa Yoshifusa
Division of Hematology, Niigata University Medical and Dental Hospital, Japan.
Intern Med. 2011;50(5):481-5. doi: 10.2169/internalmedicine.50.4481. Epub 2011 Mar 1.
We describe a 60-year-old Japanese patient with chronic myeloid leukemia (CML) who developed myelodysplastic syndrome (MDS) with Ph negative monosomy 7 chromosome following transient bone marrow dysplasia during imatinib treatment. Most cases that developed chromosomal abnormality in Ph negative cells during imatinib therapy were reported to have less clinical implications, while rare cases developed MDS/AML. The present case suggested that metaphase karyotype analysis and bone marrow examination should be performed for the long term follow-up under imatinib treatment in cases showing cytopenia. The results also suggested that monosomy 7 in Ph negative cells may be an indicator of a poor prognosis.
我们描述了一名60岁的日本慢性髓性白血病（CML）患者，该患者在伊马替尼治疗期间出现短暂性骨髓发育异常后，发展为伴有Ph阴性单体7染色体的骨髓增生异常综合征（MDS）。据报道，大多数在伊马替尼治疗期间Ph阴性细胞出现染色体异常的病例临床意义较小，而罕见病例会发展为MDS/AML。本病例提示，对于在伊马替尼治疗期间出现血细胞减少的病例，应进行中期核型分析和骨髓检查以进行长期随访。结果还提示，Ph阴性细胞中的单体7可能是预后不良的一个指标。
