Tagawa M, Tokunaga K, Kuriyama K, Jinnai I, Yoshida Y, Nonaka H, Sadamori N, Tomonaga M, Ichimaru M
Rinsho Ketsueki. 1989 Feb;30(2):232-8.
A case of AML (M 4) with t(6; 11) showed recovery to myelodysplastic syndrome (MDS)-like bone marrow after one course of DCMP regimen. Dysplastic changes of three cell-lineages were observed and micromegakaryocytes were markedly increased in number. Recovering hematopoiesis was incomplete. During MDS-like phase, t(6; 11) disappeared, reverting to normal karyotypes. Low dose ara-C regimen did not show any effect. AML soon relapsed with reappearance of t(6; 11). MDS-like abnormal hematopoiesis has recently been reported to occur after remission induction therapy or at the time of relapse. G-6PD isozyme study revealed in a remission case of AML that hematopoiesis still consisted of abnormal clone in spite of karyotypic normalization. The abnormal hematopoiesis observed in our case can be referred to such a clonal disorder predominating after disappearance of blastic component of AML. It seems important to reveal what proportion of de novo AMLs shows such an abnormal hematopoiesis and to establish suitable therapeutic approach.
1例伴有t(6; 11)的急性髓系白血病（M4）患者在接受一个疗程的DCMP方案治疗后，骨髓象恢复为骨髓增生异常综合征（MDS）样。观察到三系细胞的发育异常改变，且小巨核细胞数量明显增多。造血恢复不完全。在MDS样阶段，t(6; 11)消失，核型恢复正常。小剂量阿糖胞苷方案未显示任何效果。急性髓系白血病很快复发，t(6; 11)再次出现。最近有报道称，MDS样异常造血发生在缓解诱导治疗后或复发时。葡萄糖-6-磷酸脱氢酶（G-6PD）同工酶研究显示，在1例急性髓系白血病缓解病例中，尽管核型正常，但造血仍由异常克隆组成。我们病例中观察到的异常造血可归因于急性髓系白血病原始成分消失后占主导的这种克隆性疾病。明确初发急性髓系白血病中有多大比例表现出这种异常造血并建立合适的治疗方法似乎很重要。
