从t(8;21)急性髓性白血病到MLL基因重排阳性急性淋巴细胞白血病的表型转化。

A Ohsaka, K Kato, K Hikiji
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引用次数: 0

摘要

从急性髓性白血病(AML)到急性淋巴细胞白血病(ALL)的表型转换是罕见的。一名38岁男性最初被诊断为AML (FAB-M2)伴t(8;21)(q22;q22)染色体异常。细胞显示髓过氧化物酶(MPO)活性和CD13抗原表达。在AML的标准化疗后,他表现出完全缓解。然而,患者在停止AML治疗33个月后复发,原细胞显示ALL形态(FAB-L1)、MPO阴性和CD19抗原表达。复发时细胞遗传学分析未成功。ALL细胞分子分析显示免疫球蛋白重链基因和MLL基因重排,未见AML1基因重排。MLL基因重排或11q23染色体异常与治疗相关性白血病有关。本例患者随后的ALL可能是由含柔红霉素的化疗引起的,柔红霉素是一种拓扑异构酶II抑制剂。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Phenotypic conversion from t(8;21) acute myeloid leukemia to MLL gene rearrangement-positive acute lymphoblastic leukemia.

Phenotypic conversion from acute myeloid leukemia (AML) to acute lymphoblastic leukemia (ALL) is rare. A 38-year-old man was initially diagnosed as having AML (FAB-M2) associated with the t(8;21)(q22;q22) chromosomal abnormality. The blasts showed myeloperoxidase (MPO) activity and CD13 antigen expression. He showed complete remission after standard chemotherapy for AML. However, the patient relapsed with blasts showing ALL morphology (FAB-L1), MPO negativity, and CD19 antigen expression 33 months after cessation of AML therapy. Cytogenetic analysis at relapse was unsuccessful. Molecular analysis of ALL blasts revealed immunoglobulin heavy-chain gene and MLL gene rearrangements but no AML1 gene. MLL gene rearrangement or the 11q23 chromosomal abnormality has been associated with therapy-related leukemia. The subsequent ALL in our patient may have been induced by the chemotherapy including daunorubicin, known as a topoisomerase II inhibitor.

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