Shaw M T, Bottomley R H, Grozea P N, Nordquist R E
Cancer. 1975 Jan;35(1):199-207. doi: 10.1002/1097-0142(197501)35:1<199::aid-cncr2820350124>3.0.co;2-9.
Possible predictive criteria of the refractoriness to therapy of the blastic phase of Ph-1-positive chronic granulocytic leukemia (CGL) have been sought. Eight cases in the blastic phase were studied. The blasts were noted to be of two types: some displayed a high nuclear:cytoplasmic ratio with deep blue cytoplasm, while others had a comparatively low nuclear:cytoplasmic ratio and bluish gray cytoplasm containing a few small granules. Electron microscopic studies showed a variety of features, including defective organelles and giant mitochondria. Cytochemical staining revealed the majority of blast cells to be peroxidase- and Sudan black-negative; granular PAS positivity was the rule. Serial cytogenetic studies demonstrated increasing aneuploidy. Bone marrow biopsy showed myelofibrotic changes in two cases. Two patients entered complete remission with prednisone and vincristine and with Ara-C and thioguanine, respectively. It is concluded that the blastic phase of CGL may manifest heterogeneity.
人们一直在寻找Ph-1阳性慢性粒细胞白血病（CGL）急变期治疗难治性的可能预测标准。对8例急变期患者进行了研究。发现原始细胞有两种类型：一些核质比高，胞质深蓝色，而另一些核质比相对较低，胞质蓝灰色，含少量小颗粒。电子显微镜研究显示出多种特征，包括细胞器缺陷和巨大线粒体。细胞化学染色显示大多数原始细胞过氧化物酶和苏丹黑阴性；颗粒状PAS阳性常见。系列细胞遗传学研究显示非整倍体增多。骨髓活检显示2例有骨髓纤维化改变。2例患者分别使用泼尼松和长春新碱以及阿糖胞苷和硫鸟嘌呤后进入完全缓解期。结论是CGL急变期可能表现出异质性。
