Abstract
We report a patient with acute myelomonocytic leukemia (AMMoL) who showed two independent point mutations of the N-ras gene at codons 12 and 13. Longitudinal analysis revealed that one mutation at codon 13 was detectable throughout his disease course and the other at codon 12 emerged as a second mutation 14 months after the diagnosis was made, at the refractory stage. Cloning to vector and subsequent sequencing confirmed that these mutations occurred in different alleles. Chromosome findings showed a simple abnormal karyotype at presentation and further karyotypic aberrations during his disease course, concomitantly with the second mutation of the N-ras gene. These findings revealed a close relationship among the disease progression, karyotypic evolution and a newly-appearing N-ras mutation.
MeSH terms
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Aclarubicin / administration & dosage
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Alleles
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Antineoplastic Combined Chemotherapy Protocols / adverse effects
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use
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Chromosome Deletion
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Chromosomes, Human, Pair 12 / ultrastructure
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Chromosomes, Human, Pair 9 / ultrastructure
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Codon / genetics
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Cytarabine / administration & dosage
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Cytarabine / analogs & derivatives
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Daunorubicin / administration & dosage
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Disease Progression
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Doxorubicin / administration & dosage
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Etoposide / administration & dosage
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Fatal Outcome
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Genes, ras*
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Genetic Vectors
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Humans
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Karyotyping
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Leukemia, Myelomonocytic, Acute / drug therapy
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Leukemia, Myelomonocytic, Acute / genetics*
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Male
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Mercaptopurine / administration & dosage
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Middle Aged
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Mitoxantrone / administration & dosage
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Point Mutation*
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Prednisolone / administration & dosage
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Vinblastine / administration & dosage
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Vincristine / administration & dosage
Substances
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Codon
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Cytarabine
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Vincristine
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Vinblastine
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Etoposide
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Aclarubicin
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Doxorubicin
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Prednisolone
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enocitabine
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Mitoxantrone
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Mercaptopurine
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Daunorubicin