Hattori M, Tanaka M, Yamazaki Y, Nakahara Y, Tsushita K, Utumi M
Nagoya National Hospital, Hematological Disease Center, Japan.
Leuk Res. 1995 Jun;19(6):389-96. doi: 10.1016/0145-2126(95)00004-8.
In this paper we describe a patient with bcr/abl positive acute undifferentiated leukemia (AUL) derived from acquired sideroblastic anemia secondary to ifosphamide treatment given for the preceding non-Hodgkin lymphoma of the lung. Cytogenetically, Philadelphia chromosome was not detected through the whole course in this patient, and multiple chromosomal abnormalities including 5q- and monosomy 7 were found at the stage of sideroblastic anemia. The reverse transcriptase-polymerase chain reaction (RT-PCR) analysis showed no bcr/abl fusion transcript at the diagnosis of malignant lymphoma. The mRNA encoding the major bcr/abl fusion protein then appeared in the stage of sideroblastic anemia. Finally, the mRNA encoding both major and minor bcr/abl was detected in the stage of AUL transformation. MLL gene rearrangement was not found by RT-PCR analysis at any stage of the disorder. These results may be direct evidence for the induction of the bcr/abl fusion gene by treatment with an alkylating agent (ifosphamide).
在本文中，我们描述了一名患有bcr/abl阳性急性未分化白血病（AUL）的患者，该白血病源自继发于异环磷酰胺治疗的获得性铁粒幼细胞贫血，异环磷酰胺是用于治疗先前肺部非霍奇金淋巴瘤的药物。细胞遗传学分析显示，该患者整个病程中均未检测到费城染色体，在铁粒幼细胞贫血阶段发现了包括5q-和7号染色体单体在内的多种染色体异常。逆转录聚合酶链反应（RT-PCR）分析显示，在恶性淋巴瘤诊断时未检测到bcr/abl融合转录本。编码主要bcr/abl融合蛋白的mRNA随后出现在铁粒幼细胞贫血阶段。最后，在AUL转化阶段检测到了编码主要和次要bcr/abl的mRNA。在该疾病的任何阶段，RT-PCR分析均未发现MLL基因重排。这些结果可能是烷基化剂（异环磷酰胺）治疗诱导bcr/abl融合基因的直接证据。
