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Два новых наблюдения 8p11 миелопролиферативного синдрома с транслокациями t(6;8)(q27;p11) и t(8;9)(p11;q34), делецией гена FGFR1 и гиперэкспрессией гена evi-1: теоретические и клинические аспекты

Два новых наблюдения 8p11 миелопролиферативного синдрома с транслокациями t(6;8)(q27;p11) и t(8;9)(p11;q34), делецией гена FGFR1 и гиперэкспрессией гена evi-1: теоретические и клинические аспекты

Abstract

Представлены два новых случая редко встречающегося 8p11 миелопролиферативного синдрома (8p11 МПС). У больных имелись транслокации t(6;8)(q27;p11) и t(8;9)(p11;q33), связанные с перестройками гена FGFR1, расположенного в локусе 8р11. Во втором наблюдении отмеченная выше хромосомная перестройка сочеталась с транслокацией t(3;21)(q26;q22), которая скорее всего определяла высокую экспрессию гена EVI1 в опухолевых клетках. В обоих случаях определялся выраженный нейтрофильный лейкоцитоз (до 230 • 10 9/л) с эозинофилией, а в клинической картине наблюдалось увеличение размеров лимфатических узлов, печени и селезенки. Повторные цитогенетические и молекулярно-генетические исследования не выявляли ни Ph-хромосомы, ни повышения экспрессии гена BCR/ABL. Сдерживающая терапия гидроксимочевиной и блокаторами тирозинкиназ оказалась недостаточной, и больным провели аллогенную трансплантацию гемопоэтических стволовых клеток (алло-ТГСК). В одном наблюдении она осложнилась тяжелой реакцией трансплантат против хозяина, а во втором — несостоятельностью самого трансплантата.

Two new cases of a rare 8p11 myeloproliferative syndrome with t(6;8)(q27;p11) and t(8;9) (p11;q34) translocations associated with rearrangement of FGFR1 gene, located in locus 8p11, are presented. In the second case the above chromosomal rearrangement was combined with translocation t(3;21)(q26;q22) which was most likely responsible for EVI-1 gene hyperexpression. Both patients developed neutrophilic leukocytosis (up to 230x10 9/l) with eosinophilia and progressive lymphadenopathy, hepatoand splenomegaly. Repeated cytogenetic and molecular genetic studies revealed neither Ph chromosome nor BCR/ABL gene hyperexpression. Therapy with hydroxyurea and tyrosine kinase blocker was insufficient, and transplantation of allogenic hemopoietic stem cells was carried out. In one case it was complicated by severe graft versus host reaction, in the other by the transplant failure.

Keywords

8Р11 МИЕЛОПРОЛИФЕРАТИВНЫЙ СИНДРОМ, T(6;8), T(8;9), ГЕН FGFR1, КЛИНИЧЕСКАЯ КАРТИНА, ТЕРАПИЯ, ТРАНСПЛАНТАЦИЯ АЛЛОГЕННЫХ ГЕМОПОЭТИЧЕСКИХ СТВОЛОВЫХ КЛЕТОК

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
gold