Shiraishi Y, Taguchi H, Niiya K, Shiomi F, Kikukawa K, Kubonishi S, Ohmura T, Hamawaki M, Ueda N
Cancer Genet Cytogenet. 1982 Feb;5(1):1-24. doi: 10.1016/0165-4608(82)90037-1.
Chromosomes of bone marrow from 28 patients with acute nonlymphocytic leukemia (ANLL) (26 with AML, 2 with AMMoL), 19 of whom had chromosome abnormalities, were studied; 11 cases exhibited previously unreported karyotypic abnormalities. The marrows of two cases had 8-21 translocations associated with an iso-X chromosome in the female patient and with 9q13- and a missing Y in the male patient. Usually, AML patients with a 8-21 translocation have been considered to have a good prognosis; however, our cases had rather short survival times. Therefore, the prognosis of AML with an 8-21 translocation but associated with other abnormalities is still not clear. Centromere spreading (CS), which was originally reported in marrow cells of megaloblastic anemia (B12 and folic acid deficiency), was detected in leukemic cells, disappeared during remission, and reappeared on relapse. These findings suggest that CS may be a new type of abnormality in AML. In two patients with atypical hypoplastic anemia and hemolytic anemia, chromosome abnormalities were detected at the anemic stage. One case with CS was associated with atypical hypoplastic anemia and developed AML after 1 year; the other with 48,XY,+i(1q),+3,/12 and -14 had hemolytic anemia and developed AMMoL 3 weeks later. Interestingly, identical clones were detected both before and after the clinical diagnosis of leukemia. These cases strongly support the concept that some chromosome abnormalities precede the clinical manifestations of leukemia. The present study also revealed that lymphocytes in ANLL respond poorly to PHA in the presence of high numbers of blasts but do respond well to mitogens during remission. Therefore, the response of lymphocytes to PHA may serve as one criterion for determining remission.
对28例急性非淋巴细胞白血病（ANLL）患者（26例急性髓系白血病，2例急性单核细胞白血病）的骨髓染色体进行了研究，其中19例存在染色体异常；11例表现出以前未报道的核型异常。2例患者的骨髓存在8号与21号染色体易位，女性患者伴有一条等臂X染色体，男性患者伴有9q13和Y染色体缺失。通常，伴有8号与21号染色体易位的急性髓系白血病患者被认为预后良好；然而，我们的病例存活时间较短。因此，伴有8号与21号染色体易位但合并其他异常的急性髓系白血病的预后仍不明确。着丝粒扩展（CS）最初在巨幼细胞贫血（维生素B12和叶酸缺乏）的骨髓细胞中报道，在白血病细胞中被检测到，缓解期消失，复发时再次出现。这些发现提示CS可能是急性髓系白血病中的一种新型异常。在2例非典型再生障碍性贫血和溶血性贫血患者中，贫血期检测到染色体异常。1例伴有CS的患者患有非典型再生障碍性贫血，1年后发展为急性髓系白血病；另1例核型为48,XY,+i(1q),+3,/12和-14的患者患有溶血性贫血，3周后发展为急性单核细胞白血病。有趣的是，在白血病临床诊断前后均检测到相同的克隆。这些病例有力地支持了某些染色体异常先于白血病临床表现出现的观点。本研究还显示，在大量原始细胞存在的情况下，急性非淋巴细胞白血病患者的淋巴细胞对植物血凝素（PHA）反应较差，但在缓解期对有丝分裂原反应良好。因此，淋巴细胞对PHA的反应可作为判断缓解的标准之一。
