Inaba T, Hayashi Y, Yaginuma A, Hanada R, Yamamoto K, Nishida T, Sugita K, Nakazawa S, Mizutani S
Rinsho Ketsueki. 1989 May;30(5):726-30.
A 12-year old boy was admitted to Saitama Children's Medical Center because of fever and epistaxis. He had leukocytosis (WBC 40,800/microliters, blast 75%), anemia, thrombocytopenia and high levels of serum LDH, lysozyme, Vitamin B12, and plasma histamine. Bone marrow aspiration revealed hypercellular marrow with 31.2% blasts, 15.2% eosinophils, and 14.2% basophils. Blasts had Auer rods and were positive for peroxidase and negative for alpha-naphthyl butyrate esterase and PAS stainings. Ia, CD13 (My7), and CD19 (B4) antigens were expressed on his leukemic cells. Chromosomal study showed 46, XY, t(7;8) (q35;q22), del(9) (q13q22). Southern blot analysis using immunoglobulin constant region (C) probes revealed germline patterns of C mu, C kappa, C lambda, and breakpoint cluster region. A diagnosis of acute myelomonocytic leukemia (AMMoL, M4) was made. He attained a complete remission with daunorubicin and cytarabine, and 6 months later he received bone marrow transplantation from HLA-identical sister. This case had the common breakpoint 8q22 with ANLL with t(8;21) (q22;q22), and was unique AMMoL with proliferation of eosinophils and basophils in bone marrow.
一名12岁男孩因发热和鼻出血入住埼玉儿童医疗中心。他存在白细胞增多（白细胞计数40,800/微升，原始细胞75%）、贫血、血小板减少以及血清乳酸脱氢酶、溶菌酶、维生素B12和血浆组胺水平升高。骨髓穿刺显示骨髓细胞增多，原始细胞占31.2%，嗜酸性粒细胞占15.2%，嗜碱性粒细胞占14.2%。原始细胞有奥氏小体，过氧化物酶呈阳性，α-萘丁酸酯酶和糖原染色呈阴性。白血病细胞表达Ia、CD13（My7）和CD19（B4）抗原。染色体研究显示46, XY, t(7;8) (q35;q22), del(9) (q13q22)。使用免疫球蛋白恒定区（C）探针进行的Southern印迹分析显示Cμ、Cκ、Cλ和断裂点簇区域的种系模式。诊断为急性粒单核细胞白血病（AMMoL，M4）。他使用柔红霉素和阿糖胞苷达到完全缓解，6个月后接受了来自 HLA 相同姐姐的骨髓移植。该病例与伴有t(8;21) (q22;q22)的急性非淋巴细胞白血病（ANLL）有共同的8q22断裂点，是骨髓中嗜酸性粒细胞和嗜碱性粒细胞增殖的独特AMMoL。
