Yamashita S, Umemura T, Sadamura S, Takahira H, Nishimura J, Nawata H, Katsuno M, Okamura J, Horibe K
Third Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Acta Haematol. 1996;96(2):99-104. doi: 10.1159/000203724.
We report two patients with acute leukemias who expressed two types of bcr/abl mRNA. The first case was an 8-year-old boy with acute mixed leukemia in whom the Ph1 chromosome and p210/p190 types of bcr/abl mRNAs were detected at diagnosis. The second case was a 39-year-old male with acute nonlymphocytic leukemia transformed from myelodysplastic syndrome (refractory anemia with excess of blasts). In the latter case, the p210-type mRNA appeared after leukemic transformation, and the p190-type transcript was detected only during the late stage when the Ph1 chromosome was first observed. The leukemias in these two patients were aggressive in their clinical courses. We conclude that the dual expression of p210 and p190 types of bcr/abl is a factor indicating a poor prognosis, and that, in some patients, p190-type bcr/abl may contribute to disease progression.
我们报告了两名表达两种类型bcr/abl mRNA的急性白血病患者。第一例是一名8岁患急性混合白血病的男孩，诊断时检测到Ph1染色体以及p210/p190类型的bcr/abl mRNA。第二例是一名39岁男性，患有由骨髓增生异常综合征（原始细胞过多的难治性贫血）转化而来的急性非淋巴细胞白血病。在后一例中，p210型mRNA在白血病转化后出现，而p190型转录本仅在首次观察到Ph1染色体的晚期阶段被检测到。这两名患者的白血病临床病程进展迅速。我们得出结论，p210和p190类型bcr/abl的双重表达是预后不良的一个指标，并且在一些患者中，p190型bcr/abl可能促成疾病进展。
