Abstract
A case of abnormal chromatin clumping (ACC) which arose during the course of a myelodysplastic/myeloproliferative syndrome is described in a 61 year old woman who died of haemorrhage 43 months after diagnosis. Mature granulocytes exhibited the same nuclear abnormality described in other patients reported. Unusually, she presented with advanced splenomegaly and lymphadenopathy. This case was the third example of ACC in lymphocytes, the first with clinically confirmed lymphadenopathy. Diagnosis of this subset can be based on: older age; short duration of symptoms; no specific karyotypic damage; non-rearranged bcr; proliferative growth pattern in vitro; numerous circulating myelocytes; profound thrombocytopenia.
Full text
PDF


Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Abkowitz J. L., Fialkow P. J., Niebrugge D. J., Raskind W. H., Adamson J. W. Pancytopenia as a clonal disorder of a multipotent hematopoietic stem cell. J Clin Invest. 1984 Jan;73(1):258–261. doi: 10.1172/JCI111199. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bastion Y., Thomas X., Felman P., Campos L., Charrin C., Coiffier B. High risk myelodysplastic syndrome coexistent with chronic lymphocytic leukemia for more than 9 years: inhibition of the myeloid clone by the lymphoid clone? Leukemia. 1991 Nov;5(11):1006–1009. [PubMed] [Google Scholar]
- Bennett J. M., Catovsky D., Daniel M. T., Flandrin G., Galton D. A., Gralnick H. R., Sultan C. Proposals for the classification of the myelodysplastic syndromes. Br J Haematol. 1982 Jun;51(2):189–199. [PubMed] [Google Scholar]
- Boehm T., Rabbitts T. H. A chromosomal basis of lymphoid malignancy in man. Eur J Biochem. 1989 Oct 20;185(1):1–17. doi: 10.1111/j.1432-1033.1989.tb15074.x. [DOI] [PubMed] [Google Scholar]
- Brizard A., Huret J. L., Lamotte F., Guilhot F., Benz-Lemoine E., Giraud C., Desmarest M. C., Tanzer J. Three cases of myelodysplastic-myeloproliferative disorder with abnormal chromatin clumping in granulocytes. Br J Haematol. 1989 Jun;72(2):294–295. doi: 10.1111/j.1365-2141.1989.tb07703.x. [DOI] [PubMed] [Google Scholar]
- Colombat P. H., Renoux M., Lamagnere J. P., Renoux G. Immunologic indices in myelodysplastic syndromes. Cancer. 1988 Mar 15;61(6):1075–1081. doi: 10.1002/1097-0142(19880315)61:6<1075::aid-cncr2820610604>3.0.co;2-e. [DOI] [PubMed] [Google Scholar]
- Copplestone J. A., Mufti G. J., Hamblin T. J., Oscier D. G. Immunological abnormalities in myelodysplastic syndromes. II. Coexistent lymphoid or plasma cell neoplasms: a report of 20 cases unrelated to chemotherapy. Br J Haematol. 1986 May;63(1):149–159. doi: 10.1111/j.1365-2141.1986.tb07505.x. [DOI] [PubMed] [Google Scholar]
- Felman P., Bryon P. A., Gentilhomme O., Ffrench M., Charrin C., Espinouse D., Viala J. J. The syndrome of abnormal chromatin clumping in leucocytes: a myelodysplastic disorder with proliferative features? Br J Haematol. 1988 Sep;70(1):49–54. doi: 10.1111/j.1365-2141.1988.tb02433.x. [DOI] [PubMed] [Google Scholar]
- Gustke S. S., Becker G. A., Garancis J. C., Geimer N. F., Pisciotta A. V. Chromatin clumping in mature leukocytes: a hitherto unrecognized abnormality. Blood. 1970 May;35(5):637–658. [PubMed] [Google Scholar]
- Inoshita T. Acute lymphoblastic leukemia following myelodysplastic syndrome. Am J Clin Pathol. 1985 Aug;84(2):233–237. doi: 10.1093/ajcp/84.2.233. [DOI] [PubMed] [Google Scholar]
- Invernizzi R., Custodi P., de Fazio P., Bergamaschi G., Fenoglio C., Ricevuti G., Rosti V., Zambelli L. M., Ascari E. The syndrome of abnormal chromatin clumping in leucocytes: clinical and biological study of a case. Haematologica. 1990 Nov-Dec;75(6):532–536. [PubMed] [Google Scholar]
- Jaén A., Irriguible D., Milla F., Vallespi T., Torrabadella M., Abella E., Lafuente R., Woessner S. Abnormal chromatin clumping in leucocytes: a clue to a new subtype of myelodysplastic syndrome. Eur J Haematol. 1990 Oct;45(4):209–214. doi: 10.1111/j.1600-0609.1990.tb00459.x. [DOI] [PubMed] [Google Scholar]
- Kere J., Ruutu T., de la Chapelle A. Monosomy 7 in granulocytes and monocytes in myelodysplastic syndrome. N Engl J Med. 1987 Feb 26;316(9):499–503. doi: 10.1056/NEJM198702263160902. [DOI] [PubMed] [Google Scholar]
- Linman J. W., Bagby G. C., Jr The preleukemic syndrome (hemopoietic dysplasia). Cancer. 1978 Aug;42(2 Suppl):854–864. doi: 10.1002/1097-0142(197808)42:2+<854::aid-cncr2820420707>3.0.co;2-w. [DOI] [PubMed] [Google Scholar]
- Morel P., Bryon P. A., Guyon J. M., Coeur P., Gentilhomme O. Hémopathie maligne de type aplastique avec anomalies nucléaires majeures des granulocytes. Sem Hop. 1968 Nov 26;44(49):3026–3028. [PubMed] [Google Scholar]
- Nowell P. C. Cytogenetics of preleukemia. Cancer Genet Cytogenet. 1982 Mar;5(3):265–278. doi: 10.1016/0165-4608(82)90034-6. [DOI] [PubMed] [Google Scholar]
- Prchal J. T., Throckmorton D. W., Carroll A. J., 3rd, Fuson E. W., Gams R. A., Prchal J. F. A common progenitor for human myeloid and lymphoid cells. Nature. 1978 Aug 10;274(5671):590–591. doi: 10.1038/274590a0. [DOI] [PubMed] [Google Scholar]
- Raskind W. H., Tirumali N., Jacobson R., Singer J., Fialkow P. J. Evidence for a multistep pathogenesis of a myelodysplastic syndrome. Blood. 1984 Jun;63(6):1318–1323. [PubMed] [Google Scholar]
- SCOTT R. B. Leukaemia. Lancet. 1957 Jun 1;272(6979):1099–1103. [PubMed] [Google Scholar]
- Stark A. N., Scott C. S., Bhatt B., Roberts B. E. Myelodysplastic syndrome coexisting with acute lymphoblastic leukaemia. J Clin Pathol. 1986 Jul;39(7):728–730. doi: 10.1136/jcp.39.7.728. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tefferi A., Hoagland H. C., Therneau T. M., Pierre R. V. Chronic myelomonocytic leukemia: natural history and prognostic determinants. Mayo Clin Proc. 1989 Oct;64(10):1246–1254. doi: 10.1016/s0025-6196(12)61287-7. [DOI] [PubMed] [Google Scholar]
- Varma N., Dash S., Marwaha N., Varma S. A case of myelodysplastic syndrome with abnormal chromatin clumping in leucocytes. Br J Haematol. 1989 Sep;73(1):135–135. doi: 10.1111/j.1365-2141.1989.tb00238.x. [DOI] [PubMed] [Google Scholar]
- Wallis J. P., Joyner M. V. Acute myeloid leukaemia developing in a patient with longstanding untreated chronic lymphocytic leukaemia. Acta Haematol. 1986;75(4):229–231. doi: 10.1159/000206131. [DOI] [PubMed] [Google Scholar]
- Weil S. C., Rose V. L. A variant myelodysplastic syndrome with multilineage Pelgeroid chromatin. Am J Clin Pathol. 1986 Feb;85(2):176–179. doi: 10.1093/ajcp/85.2.176. [DOI] [PubMed] [Google Scholar]
- Wiedemann L. M., Karhi K. K., Shivji M. K., Rayter S. I., Pegram S. M., Dowden G., Bevan D., Will A., Galton D. A., Chan L. C. The correlation of breakpoint cluster region rearrangement and p210 phl/abl expression with morphological analysis of Ph-negative chronic myeloid leukemia and other myeloproliferative diseases. Blood. 1988 Feb;71(2):349–355. [PubMed] [Google Scholar]
- Winter J. N., Variakojis D., Gaynor E. R., Larson R. A., Miller K. B. Low-dose cytosine arabinoside (Ara-C) therapy in the myelodysplastic syndromes and acute leukemia. Cancer. 1985 Aug 1;56(3):443–449. doi: 10.1002/1097-0142(19850801)56:3<443::aid-cncr2820560305>3.0.co;2-q. [DOI] [PubMed] [Google Scholar]


