Drewinko B, Bollinger P, Brailas C, Moyle S, Wyatt J, Simson E, Johnston D, Trujillo J M
Br J Haematol. 1987 May;66(1):27-36. doi: 10.1111/j.1365-2141.1987.tb06886.x.
Peripheral blood samples from 118 patients with acute leukaemia (68 untreated; 50 treated) were measured with the Technicon H-6000 automated haematology analyser. This instrument provides, in addition to measurements of the classical haematology parameters (i.e. cell counts, haemoglobin concentration, etc.), a differential count on 10(4) WBC effected by means of flow cytochemistry (peroxidase content) and volume (light scatter) discrimination. Disregarding RBC and platelet counts and their volume distribution profiles, the most important diagnostic parameters for leukaemic disease were the WBC count, the WBC differential count, and the proportions of large unstained cells (LUC) and high peroxidase (HPX) cells obtained by the automated differential count as well as the mean value of the WBC peroxidase content distribution (MPA). Granulocytic leukaemias had lower MPA than normal and lymphocytic leukaemias had MPA values above normal. M1 leukaemias were also characterized by large proportions of LUC and low fractions of HPX, while M2 leukaemias showed low LUC with high HPX. M3 leukaemias had low LUC and very high HPX. M4 leukaemias had large LUC and 'monocytic' components and a modest fraction of HPX. M5 leukaemias had very large numbers of LUC, 'monocytes' and 'lymphocytes' and a normal HPX. For M1 leukaemia, the presence of less than 7% LUC following induction treatment was related to morphological changes of normal cells induced by chemotherapy while LUC above 10% usually indicated unsuccessful induction associated with the presence of residual blasts. If treatment was successful, M2 and M3 leukaemias characteristically decreased their HPX population. All M4 leukaemias studied by us failed to enter remission and continued to display high proportions of HPX and LUC. Similarly, most M5 leukaemias had a poor response to treatment and always showed a very high proportion of LUC. Untreated lymphocytic leukaemias demonstrated high LUC, normal HPX and a high proportion of 'lymphocytes'. Hairy cell leukaemias showed almost equal proportions of 'lymphocytes' and LUC. Successful chemotherapy of all lymphoid leukaemia entities was associated with rapid decreases in LUC, slower decrements of 'lymphocytes' and moderate and transient increments in HPX. Thus, flow cytochemistry can assist not only in the segregation of acute leukaemias along with FAB classification with nonmorphologic criteria, but also in the follow up of patients with these diseases.
使用Technicon H - 6000自动血液分析仪对118例急性白血病患者（68例未治疗；50例已治疗）的外周血样本进行检测。除了测量经典血液学参数（即细胞计数、血红蛋白浓度等）外，该仪器还通过流式细胞化学（过氧化物酶含量）和体积（光散射）鉴别对10⁴个白细胞进行分类计数。不考虑红细胞和血小板计数及其体积分布情况，白血病最重要的诊断参数是白细胞计数、白细胞分类计数、自动分类计数得到的大未染色细胞（LUC）和高过氧化物酶（HPX）细胞的比例以及白细胞过氧化物酶含量分布的平均值（MPA）。粒细胞白血病的MPA低于正常水平，淋巴细胞白血病的MPA值高于正常水平。M1型白血病的特征还包括LUC比例高和HPX比例低，而M2型白血病表现为LUC比例低和HPX比例高。M3型白血病LUC比例低且HPX比例非常高。M4型白血病有大量LUC和“单核细胞”成分以及适度比例的HPX。M5型白血病有大量LUC、“单核细胞”和“淋巴细胞”且HPX正常。对于M1型白血病，诱导治疗后LUC低于7%与化疗诱导的正常细胞形态变化有关，而LUC高于10%通常表明诱导失败且存在残留原始细胞。如果治疗成功，M2和M3型白血病的HPX细胞群会显著减少。我们研究的所有M4型白血病均未进入缓解期，且持续显示高比例的HPX和LUC。同样，大多数M5型白血病对治疗反应不佳，始终显示高比例的LUC。未经治疗的淋巴细胞白血病表现为LUC高、HPX正常且“淋巴细胞”比例高。毛细胞白血病显示“淋巴细胞”和LUC比例几乎相等。所有淋巴样白血病实体的成功化疗都伴随着LUC的快速下降、“淋巴细胞”的缓慢减少以及HPX的适度和短暂增加。因此，流式细胞化学不仅可以根据非形态学标准协助急性白血病的分类以及FAB分类，还可以用于这些疾病患者的随访。
