Testa J R, Oguma N, Pollak A, Wiernik P H
Blood. 1983 Jan;61(1):71-8.
Near-tetraploid clones were observed in bone marrow (BM) samples from two patients with acute leukemia. One case had a hypotetraploid clone (model chromosome range, 88-90) characterized by two apparently identical 8:21 translocations and loss of both Y chromosomes as well as by other changes. As in aneuploid patients with only a single 8:21 translocation, the cytologic features in this case were characteristic of acute myeloid leukemia with maturation. The marrow of the second patient contained immature leukemic blasts indicative of acute myeloid leukemia. The abnormal clone in this patient contained 93 chromosomes with an extra small marker. In this case we examined BM preparations that were made by several different cytogenetic methods: "direct" and 24-hr culture (with or without methotrexate synchronization). We scanned 100 consecutive mitotic cells from each of the three preparations and found almost no variation in the incidence of abnormal metaphase cells. However, in this particular case, we noted some disparity between preparations with respect to the quality of diploid mitoses versus that of near-tetraploid mitoses. This finding is discussed with near-tetraploid mitoses. This finding is discussed with regard to bias in selecting metaphase cells for banding analysis in acute leukemia in general. In both of our patients there was a close correlation between the incidence of polyploid mitoses observed in cytogenetic preparations and the incidence of bizarre blast cells found in BM smears on the same date.
在两名急性白血病患者的骨髓样本中观察到近四倍体克隆。其中一例有一个亚四倍体克隆(模型染色体范围为88 - 90),其特征为两个明显相同的8:21易位以及两条Y染色体缺失,还有其他变化。如同仅有单个8:21易位的非整倍体患者一样,该病例的细胞学特征符合伴有成熟的急性髓系白血病。第二名患者的骨髓中含有指示急性髓系白血病的未成熟白血病母细胞。该患者的异常克隆含有93条染色体及一条额外的小标记染色体。在这个病例中,我们检查了通过几种不同细胞遗传学方法制备的骨髓样本:“直接法”和24小时培养法(有或没有甲氨蝶呤同步化)。我们从这三种制备方法中的每一种连续扫描100个有丝分裂细胞,发现异常中期细胞的发生率几乎没有差异。然而,在这个特殊病例中,我们注意到在二倍体有丝分裂与近四倍体有丝分裂的质量方面,不同制备方法之间存在一些差异。结合近四倍体有丝分裂对这一发现进行了讨论。总体而言,针对急性白血病中选择中期细胞进行显带分析时的偏差对这一发现进行了讨论。在我们的两名患者中,细胞遗传学制备中观察到的多倍体有丝分裂发生率与同一天骨髓涂片上发现的奇异母细胞发生率之间存在密切相关性。