LATE APPEARANCE OF THE PHILADELPHIA-CHROMOSOME WITH MONOSOMY 7 IN A PATIENT WITH DE-NOVO AML WITH TRILINEAGE MYELODYSPLASIA

We report here a patient with de novo acute myelocytic leukemia with trilineage myelodysplasia (AML/TMDS) in whom cytogenetic analysis was normal at diagnosis and in whom Philadelphia chromosome (Ph(1)) with monosomy 7 emerged at the terminal stage of the disease. Reverse transcription polymerse chain reaction (RT-PCTR) on the Ph(1) positive specimen detected the mRNA encoding p190(bcr/abl) but did not detect mRNA encoding p210(bcr/abl), However, mRNA encoding p190(bcr/abl) was not detected at diagnosis and or at relapse, These observations support the hypothesis that late-appearing Ph(1) and monosomy 7 might be the result of clonal evolution during the course of leukemia, and p190(bcr/abl) might play a role in the terminal transformation or progression of leukemia. (C) 1995 Wiley-Liss, Inc.