McKenna R W, Bloomfield C D, Dick F, Nesbit M E, Brunning R D
Blood. 1975 Oct;46(4):481-94.
During a large clinicopathologic study of acute nonlymphocytic leukemia (ANLL), ten patients were identified in whom the leukemic blasts demonstrated striking morphologic and cytochemical similarities and who seemed to form a specific subgroup of ANLL. The patients' leukemic blasts were studied in routine blood and bone marrow preparations and by cytochemical and ultrastructural techniques. In routine smears, the blasts showed no clear evidence of differentiation. Cytochemically, the blasts exhibited strongly positive nonspecific esterase activity, which was completely inhibited by incubation with sodium fluoride, and were myeloperoxidase and sudan black B negative. Ultrastructural features of the blasts were similar to those described for monocytic leukemias. Striking clinical features included the occurrence primarily in young patients, the high frequency of lymphadenopathy at presentation, and the high incidence of post-treatment disseminated intravascular coagulation. Complete remissions were frequently initially obtained with duanorubicin in combination with various other agents and later in the disease with VP16-213. Based on the cytochemical and ultrastructural features, we concluded that this form of ANLL was a variety of acute monocytic leukemia. Recognition of the entity is important for optimal therapy.
在一项针对急性非淋巴细胞白血病（ANLL）的大型临床病理研究中，发现了10例患者，其白血病原始细胞表现出显著的形态学和细胞化学相似性，似乎构成了ANLL的一个特定亚组。对这些患者的白血病原始细胞进行了常规血液和骨髓涂片检查，并采用了细胞化学和超微结构技术进行研究。在常规涂片中，原始细胞未显示出明确的分化迹象。细胞化学分析显示，原始细胞呈现强阳性非特异性酯酶活性，与氟化钠孵育后完全被抑制，且髓过氧化物酶和苏丹黑B呈阴性。原始细胞的超微结构特征与单核细胞白血病中所描述的相似。显著的临床特征包括主要发生在年轻患者中、就诊时淋巴结病的高发生率以及治疗后弥散性血管内凝血的高发生率。最初，柔红霉素联合其他各种药物常常能使患者获得完全缓解，疾病后期使用VP16 - 213也能达到这一效果。基于细胞化学和超微结构特征，我们得出结论，这种形式的ANLL是急性单核细胞白血病的一种类型。识别这一实体对于优化治疗很重要。
