Dautel M M, François S, Bertheas M F, Baranger L, Gardais J, Boasson M, Ifrah N, Blanchet O
Laboratoire d'Hématologie, CDTS Angers, France.
Br J Haematol. 1997 Jul;98(1):210-2. doi: 10.1046/j.1365-2141.1997.1692986.x.
We report a case of chronic myelomonocytic leukaemia (CMML), which transformed first into acute myeloblastic leukaemia (AML) and then into acute lymphoblastic leukaemia (ALL). In the AML and ALL phases, chromosome analysis showed a classic Philadelphia chromosome (Ph) t(9:22)(q34:q11). Molecular studies showed breakpoint cluster region rearrangement between exons e1 and a2 compatible with a p190(bcr/abl) breakpoint as observed in Ph-positive lymphoblastic acute leukaemia. The minor (m-bcr) rearrangement was also detected during complete remission. This observation supports a multistep pathogenesis of leukaemias, and that the p190(bcr/abl) breakpoint may influence the course of the disease.
我们报告一例慢性粒单核细胞白血病（CMML），其首先转化为急性髓细胞白血病（AML），然后又转化为急性淋巴细胞白血病（ALL）。在AML和ALL阶段，染色体分析显示典型的费城染色体（Ph）t(9:22)(q34:q11)。分子研究显示外显子e1和a2之间的断裂点簇区域重排，与Ph阳性淋巴细胞急性白血病中观察到的p190(bcr/abl)断裂点相符。在完全缓解期也检测到了次要（m-bcr）重排。这一观察结果支持白血病的多步骤发病机制，并且p190(bcr/abl)断裂点可能影响疾病进程。
