Steiner Manuel, Attarbaschi Andishe, Dworzak Michael, Strobl Herbert, Pickl Winfried, Kornmüller Rosa, Haas Oskar, Gadner Helmut, Mann Georg
Department of Pediatric Hematology and Oncology,St Anna Children's Hospital, Vienna , Austria.
J Pediatr Hematol Oncol. 2010 Jan;32(1):e4-7. doi: 10.1097/MPH.0b013e3181b1ee65.
Cytochemical myeloperoxidase (MPO) positivity represents the gold standard for discrimination between lymphatic and myeloid blasts. Rarely, cytochemical MPO reaction may be positive in >or=3% of blasts with clear lymphoblastic morphology. We present 5 patients with cytochemically MPO-positive acute leukemia classified as lymphoblastic by cytomorphology and lymphoblastic (n=3) or biphenotypic (n=2) by immunophenotyping, who entered first-line treatment for lymphoblastic leukemia. The former 3 are in first remission and both with biphenotypic leukemia relapsed with acute myeloid leukemia. The study primarily shows that cytochemical MPO expression in childhood acute leukemia revealing typical lymphoblastic morphology and phenotype does rarely exist. Although a small number of patients studied, cytochemical MPO expression in acute leukemia does not seem to require myeloid leukemia treatment in case of otherwise lymphoblastic cytomorphology and phenotype.
细胞化学髓过氧化物酶（MPO）阳性是区分淋巴母细胞和髓母细胞的金标准。极少数情况下，细胞化学MPO反应在形态学上明确为淋巴母细胞的原始细胞中≥3%时可能呈阳性。我们报告了5例细胞化学MPO阳性的急性白血病患者，其细胞形态学分类为淋巴母细胞性，免疫表型为淋巴母细胞性（n = 3）或双表型（n = 2），这些患者接受了淋巴母细胞白血病的一线治疗。前3例处于首次缓解期，2例双表型白血病均复发为急性髓系白血病。该研究主要表明，在儿童急性白血病中，具有典型淋巴母细胞形态和表型的细胞化学MPO表达很少见。尽管研究的患者数量较少，但在细胞形态学和表型为其他淋巴母细胞性的情况下，急性白血病中的细胞化学MPO表达似乎不需要按照髓系白血病进行治疗。
