Drewinko B, Bollinger P, Brailas C, Wyatt J, Simson E, Trujillo J M
Division of Laboratory Medicine, University of Texas System Cancer Center, M.D. Anderson Hospital and Tumor Institute at Houston 77030.
Br J Haematol. 1987 Oct;67(2):157-65. doi: 10.1111/j.1365-2141.1987.tb02320.x.
Peripheral blood samples from 73 patients with chronic leukaemia were measured with the Technicon H-6000 automated haematology analyser to provide flow cytochemical (peroxidase content) and volume (light scatter) discriminated scattergram patterns. For chronic granulocytic leukaemia (CGL), these patterns were so reproducible and distinct that they allowed an immediate diagnosis even without the benefit of microscopic examination. Relative and absolute basophilia was an invariable feature, and remained detected by the H-6000 even when the patient was in haematologic and cytogenetic remission or progressed into blast crisis (BC). Most patients in BC also demonstrated an inordinately high number of large unstained cells (LUC) and high proportions of 'lymphocytes' (small blasts with no peroxidase content by visual inspection). Thus, for patients with CGL, LUC values above 10%, and/or steady increments in the proportion of 'lymphocytes', merit concern as these changes may herald an accelerated phase of disease. The scattergram pattern of untreated chronic lymphocytic leukaemia (CLL) showed a dense accumulation of data points within the lymphocytic 'box' with a small cluster of granulocytic elements. Most patients also had a frankly abnormal proportion of LUC. Sixteen patients with CLL were compared for ratios of LUC to lymphocytes and stage of disease; patients with the most advanced stage (IV) had the highest, statistically significant values, than the patients with more benign disease. Thus, it is possible that follow up with this instrument of patients with CLL will also allow early detection of an impending prolymphocytoid transformation (accelerated phase) of this disease.
使用Technicon H - 6000自动血液分析仪对73例慢性白血病患者的外周血样本进行检测，以提供流式细胞化学（过氧化物酶含量）和体积（光散射）区分的散点图模式。对于慢性粒细胞白血病（CGL），这些模式具有高度的可重复性和特异性，即使不借助显微镜检查也能立即做出诊断。相对和绝对嗜碱性粒细胞增多是一个恒定特征，即使患者处于血液学和细胞遗传学缓解期或进展为急变期（BC），H - 6000仍能检测到。大多数处于急变期的患者还表现出大量未染色大细胞（LUC）数量异常高，以及“淋巴细胞”比例高（通过目视检查为无过氧化物酶含量的小原始细胞）。因此，对于慢性粒细胞白血病患者，LUC值高于10%和/或“淋巴细胞”比例持续增加值得关注，因为这些变化可能预示疾病进入加速期。未经治疗的慢性淋巴细胞白血病（CLL）的散点图模式显示淋巴细胞“框”内数据点密集堆积，伴有一小群粒细胞成分。大多数患者的LUC比例也明显异常。对16例慢性淋巴细胞白血病患者的LUC与淋巴细胞比例及疾病分期进行比较；疾病最晚期（IV期）的患者具有最高的、具有统计学意义的值，高于病情较轻的患者。因此，使用该仪器对慢性淋巴细胞白血病患者进行随访也有可能早期发现该疾病即将发生的幼淋巴细胞样转化（加速期）。
