Very early onset of an acute myeloid leukemia in an adult patient with B-cell lymphoblastic leukemia
Very early onset of an acute myeloid leukemia in an adult patient with B-cell lymphoblastic leukemia
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DOI：
10.1111/j.1751-553x.2007.00968.x
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发表时间：
2009-02-01
影响因子：
3
通讯作者：
Guenova, M.
中科院分区：
文献类型：
--
作者：
Shivarov, V.;Stoimenov, A.;Guenova, M.
我们报告一例 30 岁男性急性 B 淋巴细胞白血病 (B-ALL) 病例，其免疫表型为 CD19(+)、CD22(+)、CD20(+)、CD10(+)，CD13 和 CD117 表达异常，以及 IgH 基因重排。使用 GMALL-2003 和 Ida/FLAG 方案治疗三个月后，骨髓显示出以髓系形态和表型 MPO+、CD13(+)、CD33(+)、CD64(+)、CD15(+)、CD56(+)、EVI-1 基因过度表达和缺乏 IgH 重排的原始细胞为主。该病例是首例成年患者在 B-ALL 诱导治疗期间极早期出现髓系白血病的报告。讨论了不同的发病机制——克隆进化或选择、谱系转换或从头或治疗诱导的白血病的发展。
We report on a case of a 30-year-old male with acute B-lymphoblastic leukemia (B-ALL) with immunophenotype CD19(+), CD22(+), CD20(+), CD10(+), with aberrant expression of CD13 and CD117, and IgH gene rearrangements. Three months after treatment with GMALL-2003 and Ida/FLAG protocols bone marrow showed predominance of blasts with myeloid morphology and phenotype MPO+, CD13(+), CD33(+), CD64(+), CD15(+), CD56(+), EVI-1 gene overexpression and lack of IgH rearrangements. The case is the first report of a very early emergence of myeloid leukemia during the induction treatment for B-ALL in an adult patient. Different pathogenetic mechanisms are discussed - clonal evolution or selection, lineage switch or development of a de novo or therapy-induced leukemia.