Britton V, Kwan Y L, White L, Yip M Y
Cytogenetics and Cell Biology Unit, Prince of Wales Hospital, Sydney, Australia.
Cancer Genet Cytogenet. 1990 Jul 15;47(2):265-9. doi: 10.1016/0165-4608(90)90035-9.
Trisomy 4 was the sole chromosome anomaly in a 5-year-old girl with acute leukemia. Morphologically, there appeared to be distinct myeloid and lymphoid blast cells on presentation. Immunophenotyping, however, showed extensive overlap of myeloid and lymphoid markers, confirming the leukemia to be biphenotypic rather than true "bilineal." She attained remission only after lymphoid-cell-specific induction was added to the initial "myeloid type" induction. She relapsed 4 years later with morphologically acute lymphocytic leukemia (French-American-British L2 type) despite still retaining the original immunophenotypic characteristics. She was successfully reinduced and subsequently received an autologous bone marrow transplant. Second relapse, morphologically and immunophenotypically similar to the first, occurred 5 months after transplant.
4号染色体三体是一名5岁急性白血病女童唯一的染色体异常。形态学上，初诊时可见明显的髓系和淋巴系原始细胞。然而，免疫表型分析显示髓系和淋巴系标志物有广泛重叠，证实该白血病为双表型而非真正的“双系”。仅在初始的“髓系型”诱导方案中加入淋巴细胞特异性诱导后，她才达到缓解。4年后，尽管仍保留原免疫表型特征，但她复发为形态学上的急性淋巴细胞白血病（法美英L2型）。她成功再次诱导缓解，随后接受了自体骨髓移植。移植后5个月发生第二次复发，形态学和免疫表型与第一次相似。
