Kobayashi H, Kaneko Y, Maseki N, Sakurai M
Department of Cancer Chemotherapy, Saitama Cancer Center Hospital, Japan.
Cancer Genet Cytogenet. 1990 Jul 15;47(2):171-8. doi: 10.1016/0165-4608(90)90027-8.
Karyotypically unrelated clones were observed in nine of 399 newly diagnosed acute leukemia or myelodysplastic syndrome (MDS) patients: two (3.0%) of 66 French-American-British classification (FAB)-M2 patients, five (12.5%) of 40 M5 patients, one (20%) of five chronic myelomonocytic leukemia (CMMoL), patients, one (12.5%) of eight refractory anemia with excess blasts in transformation (RAEBT) patients, and none (0%) of 177 acute lymphoblastic leukemia patients had such clones. Cytogenetically unrelated clones occurred more frequently in FAB-M5 than in the other subtypes of AL or MDS (p less than 0.01). Five (55%) of the nine patients had trisomy 8, two (22%) had partial deletion of the long arm of chromosome 5 and two had (22%) trisomy 11. Patients had short survival times (median 2 months, range 1-26 months) after detection of unrelated clones; eight of the nine failed to respond to chemotherapy. None of our patients had two phenotypically different leukemic cell populations or underwent phenotypic conversion of leukemic cells during the course of the disease. These findings suggest that the unrelated clones may have been derived from the common leukemic clone without microscopic chromosome changes, and that the different chromosome abnormalities of the unrelated clones may represent additional genetic changes in leukemogenesis.
在399例新诊断的急性白血病或骨髓增生异常综合征（MDS）患者中，观察到9例核型不相关的克隆：66例法国-美国-英国分类法（FAB）-M2患者中有2例（3.0%），40例M5患者中有5例（12.5%），5例慢性粒单核细胞白血病（CMMoL）患者中有1例（20%），8例转化型难治性贫血伴原始细胞增多（RAEBT）患者中有1例（12.5%），而177例急性淋巴细胞白血病患者中无一例有此类克隆。细胞遗传学上不相关的克隆在FAB-M5中比在急性白血病（AL）或MDS的其他亚型中更常见（p<0.01）。9例患者中有5例（55%）有8号染色体三体，2例（22%）有5号染色体长臂部分缺失，2例（22%）有11号染色体三体。检测到不相关克隆后患者的生存时间较短（中位时间2个月，范围1 - 26个月）；9例中有8例对化疗无反应。我们的患者中没有一例在疾病过程中有两种表型不同的白血病细胞群或经历白血病细胞的表型转化。这些发现表明，不相关的克隆可能源自无微观染色体变化的共同白血病克隆，并且不相关克隆的不同染色体异常可能代表白血病发生过程中的额外基因变化。
