Tamura J, Kurabayashi H, Sawamura M, Murakami H, Nogiwa E, Shinonome S, Miyawaki S, Kubota K, Sato S, Omine M
Third Department of Medicine, Gunma University School of Medicine, Japan.
Blut. 1989 May;58(5):229-33. doi: 10.1007/BF00320910.
Four patients with common acute lymphoblastic leukemia antigen (CALLA)-positive myeloma are presented. The subclasses of monoclonal protein were IgD kappa (1 case), IgA lambda (1 case), and IgA kappa (2 cases). Bence Jones proteinuria was seen in all cases. The clinical stages were determined as IIA (2 cases) and IIIA (2 cases). All patients died with a median survival time after diagnosis of 62 days due to rapid development of renal failure (3 cases), and renal insufficiency and pneumonia (1 case). According to light microscopic evaluation, these myelomas corresponded to plasmablastic (1 case), immature (2 cases), and intermediate (1 case) types. Both CALLA and a cytoplasmic immunoglobulin identical with the serum monoclonal protein were simultaneously detected in single cells from all cases using immunofluorescent double labeling. These findings suggest that CALLA-positive and plasma-blastic myelomas constitute clinically a subgroup characterized by extremely poor survival but they represent cytologically different subcategories.
本文报告了4例普通急性淋巴细胞白血病抗原（CALLA）阳性的骨髓瘤患者。单克隆蛋白的亚类分别为IgD κ（1例）、IgA λ（1例）和IgA κ（2例）。所有病例均出现本周蛋白尿。临床分期确定为IIA期（2例）和IIIA期（2例）。所有患者均因肾衰竭迅速发展（3例）以及肾功能不全和肺炎（1例）在诊断后中位生存时间62天死亡。根据光镜评估，这些骨髓瘤分别对应浆母细胞型（1例）、未成熟型（2例）和中间型（1例）。使用免疫荧光双重标记在所有病例的单个细胞中同时检测到CALLA和与血清单克隆蛋白相同的细胞质免疫球蛋白。这些发现表明，CALLA阳性和浆母细胞性骨髓瘤在临床上构成一个以生存极差为特征的亚组，但它们在细胞学上代表不同的亚类。
