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AKUT LÖSEMİDE DİZİ KAYMASI: OLGU SUNUMU

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 2001

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Lineage switch in acule leukemia: Cases reports. A case of acute lymphoblastic leukemia that underwent a lineage switch to acute myeloid leukemia at relapse is described. The original leukemia had typical lenfoblastic features, as evidenced by clinical behaviour, blast celi morp-hology (FAB L2) and immunophenotype (CD19, CD20 and CD22 were positive). After suc-cessful remission induction with standart chemotherapy, extramedullary relapses (first skin, then testis) occurred and were followed immediately by medullary relapse. The absence of two previous lenfoid markers and the presence of two myeloid markers suggested a lineage svvitch in patient's leukemic blast cells. Immunophenotypic switch in most of the cases reported have been in the same direction (from ALL to AML). Mechanisms underlying lineage switch have been poorly understood. Possible explanations are discussed. This case supports the need for careful and comprehensive analy-sis and immunophenotyping of blast cells in case of relapse before assuming that the relapse is in the same lineage.
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Abstract (Original Language): 
Akut lenfoblastik lösemi olarak başlayıp akut miyeloid lösemi olarak nüks eden bir olgu sunuyoruz. Başlangıçtaki löseminin klinik özellikleri, hücre morfolojisi (FAB L2) ve immunofeno-tipi (CD19 CD20 ve CD22 pozitif) lenfoblastik lösemi ile uyum gösteriyordu. Standart kemo-terapi ile remisyon elde edildi. İdame tedavi altındayken ekstramedüller nüksler (deri, testis) ortaya çıktı. Ardından kemik iliği nüksü oldu. Nüksteki blastlarda başlangıçtakine göre 2 len-foid belirteç yoktu, ancak 2 miyeloid belirteç taşıyorlardı. Bu bulgular blastik hücrelerde dizi kayması olduğunu düşündürdü. Şimdiye dek bildirilen dizi kaymalarının büyük bir kısmında immunofenotipik değişme lenfoidden miyeloide doğrudur. Dizi kaymasının sebebi kesin olarak anlaşılamamıştır. Dizi kayma mekanizmaları yazıda tartışıldı. Sunulan bu olgu, akut lösemide nüks meydana geldiğinde incelemelerin titizlikle tekrarlanması gereğini göstermektedir.
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  • 4
316-320
  • Turkish

REFERENCES

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