Takesako T, Murakami S, Haruyama H, Oku N, Takeda N, Itoh K, Fujita N, Nakanish S, Shimazaki C, Isemura T
Rinsho Ketsueki. 1989 Jun;30(6):882-6.
A 71-year old male was admitted to our hospital because of general malaise and fever. Peripheral blood showed Hb 8.1 g/dl, platelet 7.0 X 10(4)/microliters, and WBC 18.100/microliters with 64% leukemic cells. Bone marrow showed normocellularity with 73.4% leukemic cells. They were positive for peroxidase and alpha-naphthyl butyrate esterase stainings. Serum and urine lysozyme levels were elevated. He was diagnosed as having acute myelomonocytic leukemia (M 4 in FAB classification). Chromosome analysis of bone marrow cells showed 45, XY, -17, t (9; 17) (q22; p13) and double minute chromosomes (DMs) were observed in the 50 cells analyzed. A complete remission (CR) was obtained by DCMP regimen, but he relapsed as acute monocytic leukemia (M 5 b in FAB classification) and died 5 months after diagnosis. DMs appear to be rare in acute leukemia and the clinical and etiologic implications of DMs are discussed.
一名71岁男性因全身不适和发热入院。外周血检查显示血红蛋白（Hb）8.1g/dl，血小板7.0×10⁴/微升，白细胞（WBC）18100/微升，其中白血病细胞占64%。骨髓检查显示细胞数量正常，白血病细胞占73.4%。这些细胞过氧化物酶和α-萘丁酸酯酶染色呈阳性。血清和尿液溶菌酶水平升高。他被诊断为急性粒单核细胞白血病（FAB分类为M4）。对骨髓细胞进行染色体分析显示为45，XY，-17，t（9；17）（q22；p13），在所分析的50个细胞中观察到双微体染色体（DMs）。采用DCMP方案获得了完全缓解（CR），但他复发为急性单核细胞白血病（FAB分类为M5b），并在诊断后5个月死亡。双微体染色体在急性白血病中似乎很少见，本文讨论了双微体染色体的临床和病因学意义。
