Eridani S, Parry H, Glass U, Greaves M
Cancer. 1984 Aug 1;54(3):397-9. doi: 10.1002/1097-0142(19840801)54:3<397::aid-cncr2820540305>3.0.co;2-p.
A case is presented of a patient with classical chronic lymphatic leukemia (CLL) treated with continuous chlorambucil for 3 years who presented with a picture of acute leukemia. The peripheral blood still showed a prevalence of mature lymphocytes with a few blast cells, whereas the bone marrow showed a predominant population of blast cells possessing a null acute lymphoblastic leukemia phenotype. Karyotype analysis showed a prevalent hyperdiploid clone of 67 to 68 chromosomes with endoreduplication and marker chromosomes. The coexistence of a CLL-type population with the blastic, undifferentiated cell clone suggests a second malignancy superimposed on the previous leukemic process, and possibly brought about by the continuous chlorambucil treatment.
本文报告了一例经典型慢性淋巴细胞白血病（CLL）患者，该患者接受苯丁酸氮芥持续治疗3年，之后出现急性白血病表现。外周血仍以成熟淋巴细胞为主，伴有少数原始细胞，而骨髓中则以具有急性淋巴细胞白血病无表型的原始细胞为主。核型分析显示，存在一个普遍的超二倍体克隆，有67至68条染色体，伴有核内复制和标记染色体。CLL型细胞群与原始、未分化细胞克隆并存，提示在先前的白血病病程基础上发生了第二种恶性肿瘤，可能是由持续的苯丁酸氮芥治疗引起的。
