Shikano T, Ishikawa Y, Ohkawa M, Hatayama Y, Nakadate H, Hatae Y, Takeda T
Department of Pediatrics, Hokkaido University School of Medicine, Sapporo, Japan.
Leukemia. 1990 Jun;4(6):419-22.
Cytogenetic study was performed at both diagnosis and relapse in 31 children with acute leukemia who had initially abnormal karyotypes, 21 with acute lymphocytic leukemia (ALL) and 10 with acute nonlymphocytic leukemia (ANLL). Seventy percent of the patients showed karyotypic changes between diagnosis and relapse. The ALL patients showed karyotypic changes more often than the ANLL patients (76 vs. 40%)(chi-square test, p less than 0.05). All the initially abnormal patients with karyotypic changes exhibited structural changes, most frequently chromosome 1 abnormalities, especially in ANLL, and 6q-, 7p-, 9p- in ALL. Half of the patients, with structural karyotypic change had two or more clonally related cell lines at relapse. On the other hand, only 20% of the patients with karyotypic changes showed numerical changes. All but one of the initially abnormal patients showed karyotypic changes involving the original cytogenetically abnormal clone. Our study demonstrated that sequential cytogenetic studies may provide a better understanding of the nature of leukemia relapse.
对31例初诊时核型异常的急性白血病患儿进行了诊断时和复发时的细胞遗传学研究，其中21例为急性淋巴细胞白血病（ALL），10例为急性非淋巴细胞白血病（ANLL）。70%的患者在诊断和复发之间出现了核型变化。ALL患者比ANLL患者更常出现核型变化（76%对40%）（卡方检验，p<0.05）。所有初诊时核型异常且发生核型变化的患者均表现为结构改变，最常见的是1号染色体异常，尤其是在ANLL中，而在ALL中最常见的是6q-、7p-、9p-。一半核型结构改变的患者在复发时有两个或更多克隆相关的细胞系。另一方面，只有20%核型变化的患者表现为数目改变。除1例患者外，所有初诊时核型异常的患者均表现出涉及原始细胞遗传学异常克隆的核型变化。我们的研究表明，连续的细胞遗传学研究可能有助于更好地理解白血病复发的本质。
