Stein J, Zimmerman P A, Kochera M, Strandjord S, Golden W, Simon M, Warkentin P, Blazar B R, Coccia P, Lang-Unnasch N
Department of Pediatrics, Case Western Reserve University, Cleveland.
Blood. 1989 May 15;73(7):2033-40.
Leukemic relapse following bone marrow transplant (BMT) is generally due to the recurrence in recipient cells, but may rarely occur as a result of donor cell transformation. Donor cell relapse is generally identified using cytogenetic markers such as the sex chromosomes. Recently, molecular techniques have been used to identify the origin of bone marrow cells by their DNA restriction fragment length polymorphisms. We describe the case of a male pediatric patient who had a leukemic relapse 30 months following BMT from his sister. Both cytogenetic and molecular techniques were used to identify the origin of the leukemic relapse. Cytogenetic analyses indicated the absence of the Y chromosome and the presence of a donor cell type 9qh polymorphism, suggesting a donor cell relapse. Molecular analyses also indicated the absence of the Y chromosome but demonstrated the recurrence of recipient DNA markers from three other chromosomes, suggesting a recipient cell relapse. While the leukemic cell lineage cannot be definitively assigned in this case, our results suggest that caution must be exercised when assigning leukemic cell lineage following post-BMT relapse.
骨髓移植（BMT）后白血病复发通常是由于受体细胞中的复发，但很少是由于供体细胞转化导致的。供体细胞复发通常使用细胞遗传学标记物（如性染色体）来识别。最近，分子技术已被用于通过DNA限制性片段长度多态性来识别骨髓细胞的起源。我们描述了一名男性儿科患者的病例，该患者在接受其姐姐的BMT后30个月出现白血病复发。细胞遗传学和分子技术均被用于识别白血病复发的起源。细胞遗传学分析表明Y染色体缺失，存在供体细胞类型9qh多态性，提示供体细胞复发。分子分析也表明Y染色体缺失，但显示来自其他三条染色体的受体DNA标记物复发，提示受体细胞复发。虽然在这种情况下不能明确确定白血病细胞系，但我们的结果表明，在BMT后复发后确定白血病细胞系时必须谨慎。
