Smith J L, Heerema N A, Provisor A J
Br J Haematol. 1985 Jul;60(3):415-22. doi: 10.1111/j.1365-2141.1985.tb07438.x.
Recurrent leukaemia following bone marrow transplantation is most often due to the regrowth of original host leukaemia cells, but may also be due to the malignant transformation of normal donor marrow cells after transplantation into a leukaemia patient. We report the ninth case of malignant change in cells of donor origin in a 12-year-old boy who was originally diagnosed as having Ph1+ CML. He remained Ph1+ during lymphoid blast crisis. After transplantation with marrow from a cytogenetically normal sister, he relapsed to Ph1- ALL in the female donor cells. The marrow showed a mixed karyotype of 46,XX/46,XX,inv(9)(p12q12). It would appear that, haematologically, the patient showed different manifestations of the same disease state. Cytogenetically, however, the pre- and post-transplant leukaemias were different.
骨髓移植后复发的白血病最常见的原因是原来宿主白血病细胞的再生，但也可能是正常供体骨髓细胞在移植到白血病患者体内后发生恶性转化所致。我们报告了第九例供体来源细胞发生恶性变化的病例，患者为一名12岁男孩，最初诊断为Ph1+慢性粒细胞白血病。在淋巴母细胞危象期间，他仍为Ph1+。在用细胞遗传学正常的姐姐的骨髓进行移植后，他在女性供体细胞中复发为Ph1-急性淋巴细胞白血病。骨髓显示出46,XX/46,XX,inv(9)(p12q12)的混合核型。从血液学角度看，该患者似乎表现出同一疾病状态的不同表现。然而，从细胞遗传学角度看，移植前和移植后的白血病是不同的。
