Raynaud S D, Brunet B, Chischportich M, Bayle J, Gratecos N, Pesce A, Dujardin P, Flandrin G, Ayraud N
Laboratoire de Génétique-URA CNRS 1462, Nice, France.
Leukemia. 1994 Feb;8(2):245-9.
We have undertaken the cytogenetic monitoring of 39 adult patients treated for de novo acute myeloid leukemia (AML) by intensive chemotherapy. We describe this monitoring in seven patients in continuous complete clinical and morphologic remission (CR) of AML. Although in CR, these patients exhibit the emergence of cytogenetically abnormal clones. Abnormalities observed include monosomy 7, del(20)(q11), partial trisomy 1q, and 6p12-22 rearrangements. They correspond to well-known chromosomal rearrangements commonly found in myelodysplasia (MDS), and myeloproliferative syndromes (MPS), as well as AML. Present as the sole detected chromosomal change, they preceded by months the onset of overt leukemia or MDS. In some cases, the abnormal clone showed a proliferative advantage (some patients exhibited up to 100% of abnormal bone marrow metaphases in subsequent analyses). AML relapse, when it occurred, was associated with a different chromosomal modification. Altogether the question arises, whether the abnormalities pointed out in our study (monosomy 7, del(20)(q11), partial trisomy for the long arm of chromosome 1 (q21qter), 6p12-22 rearrangements), and seen after chemotherapy, mark preleukemic cells or not, and whether they participate indirectly, or not at all in the leukemic process.
我们对39例接受强化化疗的初发性急性髓系白血病（AML）成年患者进行了细胞遗传学监测。我们描述了7例处于AML持续完全临床和形态学缓解（CR）状态患者的这种监测情况。尽管处于CR状态，但这些患者出现了细胞遗传学异常克隆。观察到的异常包括7号染色体单体、del(20)(q11)、1号染色体长臂部分三体以及6p12 - 22重排。它们对应于骨髓增生异常综合征（MDS）、骨髓增殖性综合征（MPS）以及AML中常见的知名染色体重排。作为唯一检测到的染色体变化出现时，它们在明显白血病或MDS发病前数月出现。在某些情况下，异常克隆显示出增殖优势（一些患者在后续分析中显示高达100%的异常骨髓中期分裂相）。AML复发时，与不同的染色体改变相关。总之，问题出现了，我们研究中指出的异常（7号染色体单体、del(20)(q11)、1号染色体长臂（q21qter）部分三体、6p12 - 22重排），在化疗后出现，是否标志着白血病前期细胞，以及它们是否间接参与或根本不参与白血病过程。
