Harth H, Pees H, Zankl H
Division of Human Biology and Human Genetics University of Kaiserslautern, F.R.G.
Cancer Genet Cytogenet. 1988 Jul 15;33(2):185-91. doi: 10.1016/0165-4608(88)90028-3.
An unusual case of acute leukemia with mixed phenotype was followed up from diagnosis to death for about 12 months. The first cytogenetic examination revealed about 80% of the bone marrow cells in the diploid and 20% in the tetraploid range. After two courses of induction therapy, complete remission was achieved within 2 months. At this time the tetraploid cells were reduced to 3%, but 50% of the mitoses showed a Y chromosome loss, while the other mitoses had a diploid karyotype. Early intensification therapy was given 6 weeks later with slow recovery of blood counts. After four months a sharp decrease of the number of Y-missing mitoses was observed, while the marrow remained in full remission. Two months later a relapse occurred and the patient died. At this time the -Y clone had dropped to 2% and the tetraploid clone was totally absent. We conclude from these findings that the diploid clone was the most malignant one, whereas the -Y cells were probably not directly involved in the leukemic process.
对一例罕见的混合表型急性白血病患者从诊断到死亡进行了约12个月的随访。首次细胞遗传学检查显示，约80%的骨髓细胞处于二倍体范围，20%处于四倍体范围。经过两个疗程的诱导治疗，2个月内实现了完全缓解。此时四倍体细胞减少至3%，但50%的有丝分裂显示Y染色体缺失，而其他有丝分裂具有二倍体核型。6周后进行了早期强化治疗，血细胞计数恢复缓慢。4个月后，观察到Y染色体缺失的有丝分裂数量急剧下降，而骨髓仍处于完全缓解状态。2个月后复发，患者死亡。此时，-Y克隆已降至2%，四倍体克隆完全消失。从这些发现中我们得出结论，二倍体克隆是最具恶性的，而-Y细胞可能未直接参与白血病过程。
