Paietta E, Rosen N, Roberts M, Papenhausen P, Wiernik P H
Cancer Genet Cytogenet. 1987 Apr;25(2):227-31. doi: 10.1016/0165-4608(87)90182-8.
The Philadelphia chromosome with the classic translocation t(9;22) was detected in all metaphases of a patient with essential thrombocythemia who presented without hematologic signs of chronic myeloid leukemia (CML). After 12 months of treatment with hydroxyurea followed by 6 months of busulfan, the disease transformed into lymphoid blast crisis with the immunophenotype of pre-pre-B cells frequently seen in lymphoid blast crisis of CML. This progression was not associated with karyotypic evolution because lymphoblasts contained only the Philadelphia chromosome. Further clinical course in this patient confirmed the development of a Philadelphia chromosome positive stem cell with predominantly megakaryocytic committment through partially megakaryocytic/lymphoid differentiation to purely lymphoid committment, a previously unreported transformation.
在一名原发性血小板增多症患者的所有中期分裂相中均检测到具有经典易位t(9;22)的费城染色体，该患者无慢性髓性白血病（CML）的血液学体征。在用羟基脲治疗12个月后接着用白消安治疗6个月，疾病转变为淋巴母细胞危象，其免疫表型为CML淋巴母细胞危象中常见的前前B细胞型。这种进展与核型演变无关，因为淋巴母细胞仅含有费城染色体。该患者的进一步临床病程证实了一个费城染色体阳性干细胞的发展，其主要为巨核细胞定向，通过部分巨核细胞/淋巴细胞分化至纯淋巴细胞定向，这是一种先前未报道的转变。
