Banno S, Hirashima N, Noda T, Nitta M
Rinsho Ketsueki. 1989 Nov;30(11):1987-91.
We report a patient with acute nonlymphocytic leukemia (FAB classification: M 2) with trisomy 4, which is the first case in our country. A 42-year-old man was admitted to our hospital because of fever and general fatigue in May, 1988. His WBC count was 8,100/microliters with 90% of leukemic cells and bone marrow smear showed 76.1% leukemic cells. The chromosomal analysis of marrow cells by G-banding revealed 47, XY, +4. In spite of administration of chemotherapy complete remission was not obtained, and he died of septic shock and severe liver damage 4 months after making the diagnosis. Chromosomal abnormality of trisomy 4 has been reported to be associated with predominantly either M 4 or M 2, and to be less than 0.1% of incidence in ANLL, according to the Second MIC Cooperative Study Group. It is suggested that trisomy 4 may be caused by exposure to some environmental factors such as toxic substances, since this chromosomal abnormality has been reported in the last 10 to 20 years.
我们报告了一例患有急性非淋巴细胞白血病（FAB 分类：M2）且伴有 4 号染色体三体的患者，这是我国首例此类病例。一名 42 岁男性因发热和全身乏力于 1988 年 5 月入院。他的白细胞计数为 8100/微升，其中 90%为白血病细胞，骨髓涂片显示白血病细胞占 76.1%。通过 G 显带对骨髓细胞进行染色体分析，结果显示为 47，XY，+4。尽管进行了化疗，但仍未获得完全缓解，确诊 4 个月后，他死于感染性休克和严重肝损伤。根据第二届 MIC 协作研究组的报告，4 号染色体三体的染色体异常主要与 M4 或 M2 相关，在急性非淋巴细胞白血病中的发生率低于 0.1%。由于在过去 10 至 20 年中已报道过这种染色体异常，提示 4 号染色体三体可能是由接触某些环境因素如有毒物质引起的。
