Hann H W, Nowell P C, Koch P, Minowada J, Leitmeyer J E, August C S
J Natl Cancer Inst. 1982 Aug;69(2):393-9.
We studied cell surface markers and chromosomes in the leukemia cells of a boy with the initial diagnosis of acute lymphocytic leukemia during 18 months from diagnosis to demise. During this time he received induction therapy, underwent bone marrow transplantation, and relapsed. The leukemia cells expressed three membrane phenotypes during different stages of disease: T-cell at diagnosis; T-cell, B-cell, and monocyte during the induction period; T-cell in the first relapse after bone marrow transplantation; and T-cell and B-cell during the terminal stage. Some cells expressed markers of two cell types, indicating a common origin of these cells. Cytogenetic studies during post-transplantation relapse showed abnormal marker chromosomes that indicated two major sublines. However, there was enough sharing of other aberrant chromosomes to suggest that these two populations presented sublines within the same neoplastic clone. We suggest that these leukemia cells were derived from a pluripotential cell prior to differentiation into cells of the lymphoid and monocytic series. This particular case may represent a subset of acute leukemia and may account for the resistance to conventional therapy.
我们对一名初诊为急性淋巴细胞白血病的男孩的白血病细胞进行了18个月的研究，从诊断到死亡。在此期间，他接受了诱导治疗，进行了骨髓移植，并复发。白血病细胞在疾病的不同阶段表达了三种膜表型：诊断时为T细胞；诱导期为T细胞、B细胞和单核细胞；骨髓移植后的首次复发时为T细胞；终末期为T细胞和B细胞。一些细胞表达了两种细胞类型的标志物，表明这些细胞有共同的起源。移植后复发期间的细胞遗传学研究显示异常标记染色体，表明有两个主要亚系。然而，其他异常染色体有足够的共享，表明这两个群体是同一肿瘤克隆内的亚系。我们认为这些白血病细胞来源于一个多能细胞，在分化为淋巴系和单核系细胞之前。这个特殊病例可能代表急性白血病的一个子集，可能是对传统治疗耐药的原因。
