Goldstone A H, McVerry B A, Janossy G, Walker H
Blood. 1979 May;53(5):892-8.
In a case of acute lymphoblastic leukemia, two distinct types of leukemia blast cells could be identified throughout the course of the disease. The initially dominant type of blast cell was sensitive to chemotherapy; the other was drug-resistant, gradually becoming dominant as the disease progressed. The cell types could be clearly separated by their morphologic and surface membrane marker characteristics. The same chromosomal constitution was present in both types of blast cells, indicating a common clonal origin. Additional chromosomal abnormalities were present in the later stages of the disease, demonstrating that a distinct subclone had proliferated. This study illustrates that in some cases of acute leukemia, disease relapse is caused by growth of drug-resistant subclones that may be clearly identified by changes in morphology and surface membrane marker characteristics.
在一例急性淋巴细胞白血病病例中，在疾病全过程中可识别出两种不同类型的白血病原始细胞。最初占主导的原始细胞类型对化疗敏感；另一种则耐药，随着疾病进展逐渐成为主导类型。这两种细胞类型可通过其形态学和表面膜标志物特征清晰区分。两种原始细胞类型具有相同的染色体组成，表明它们有共同的克隆起源。在疾病后期出现了额外的染色体异常，表明有一个独特的亚克隆发生了增殖。本研究表明，在某些急性白血病病例中，疾病复发是由耐药亚克隆的生长所致，这些亚克隆可通过形态学和表面膜标志物特征的变化而明确识别。
