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[CD7 (+) stem cell leukemia presenting different phenotypes in lymph node and bone marrow].

H Goda1, Y Abe, Y Yufu

  • 1Third Department of Internal Medicine, Faculty of Medicine, Kyushu University.

[Rinsho Ketsueki] the Japanese Journal of Clinical Hematology
|August 1, 1992
PubMed
Summary
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This study tracks a patient initially diagnosed with lymphoblastic lymphoma who later relapsed with myeloblasts. Genetic analysis revealed both cell types originated from the same clone, suggesting a stem cell origin for this leukemia.

Area of Science:

  • Hematology
  • Oncology
  • Molecular Biology

Background:

  • Lymphoblastic lymphoma is a type of non-Hodgkin lymphoma.
  • Treatment protocols like MACOP-B are used for lymphoma.
  • Relapse in lymphoma can present with different cell phenotypes.

Observation:

  • A 27-year-old male initially diagnosed with lymphoblastic lymphoma showed complete remission after MACOP-B therapy.
  • The patient relapsed with cervical lymphadenopathy and bone marrow myeloblasts.
  • Initial lymphoblasts and relapsed myeloblasts shared common genetic abnormalities (11p-, T-cell receptor gene rearrangement).

Findings:

  • Cytogenetic and genetic studies confirmed a single clone origin for both lymphoblastic lymphoma and subsequent myeloblasts.
  • Despite originating from the same clone, the relapsed blasts exhibited distinct phenotypes (peroxidase-positive myeloblasts in bone marrow vs. peroxidase-negative in lymph nodes).

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Implications:

  • This case suggests a pluripotent stem cell origin for the observed leukemia.
  • The findings support the hypothesis that leukemia can arise from a stem cell and differentiate along multiple lineages.
  • Understanding clonal evolution is crucial for diagnosing and treating relapsed hematologic malignancies.