Sequential development of distinct clonal chromosome abnormalities in a patient with preleukaemia

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Abstract
Preleukemia was identified as a clonal hemopathy in which progression to acute leukemia involves conservation of the preleukemic karyotype in the blast cells or the development of new abnormalities superimposed on the original clone. A case of childhood preleukemia is presented in which 2 cytogenetically distinct clones developed over 2 yr in a dysplastic marrow that was initially karyotypically normal. One clone with 47 chromosomes (47, XY, +21), disappeared without therapy. Predominance of the cytogenetically abnormal clone, 45,XY, -12, -17,t(12;17)(p11;q11) was associated with the development of independent clonal abnormalities in the unstable preleukemic marrow may occur more commonly than was previously recognized. Implications of the progression of the karyotypic abnormalities are disucssed.