Takahira H, Ideguchi H, Hirata J, Nishimura J, Nawata H, Shimizu S
Rinsho Ketsueki. 1989 Feb;30(2):251-5.
A 33-year-old female was admitted to St. Marianna University hospital in April 1983 for the purpose of examination for leukocytosis. Physical examination revealed a marked splenomegaly. The white cell count was 174 x 10(9)/l. The hemoglobin was 9.0 g/dl and the platelet was 790 x 10(9)/l. Microscopical examination of aspirated specimen of bone marrow revealed hypercellularity with granulocytic hyperplasia. The chromosomal analysis of bone marrow cells showed Philadelphia chromosomes in all metaphases analyzed. The neutrophil alkaline phosphatase activity was reduced. A diagnosis of CML was made. She was treated with busulfan in a dose of 2 mg/day until the white cell count was 14.5 x 10(9)/l. She has been followed without any therapy and clinical remission state has been continued. In April 1985, the chromosomal analysis of bone marrow cells revealed the recovery of normal karyotype hemopoiesis in 57% of metaphases analyzed. These findings of this case suggest that some of Ph1-positive cells may reduce their growth advantage over normal cells without any bone marrow hypoplasia.
一名33岁女性于1983年4月因白细胞增多症检查入住圣玛丽安娜大学医院。体格检查发现脾脏明显肿大。白细胞计数为174×10⁹/L。血红蛋白为9.0g/dl，血小板为790×10⁹/L。骨髓穿刺标本显微镜检查显示细胞增多伴粒细胞增生。骨髓细胞染色体分析显示所有分析的中期细胞均有费城染色体。中性粒细胞碱性磷酸酶活性降低。诊断为慢性粒细胞白血病。她接受了每日2mg白消安的治疗，直至白细胞计数降至14.5×10⁹/L。此后未进行任何治疗，一直对其进行随访，临床缓解状态持续存在。1985年4月，骨髓细胞染色体分析显示，在分析的中期细胞中，57%恢复了正常核型造血。该病例的这些发现表明，一些Ph1阳性细胞可能在不发生任何骨髓发育不全的情况下，降低其相对于正常细胞的生长优势。
