Mayer S, Falkenrodt A, Albert A, Audhuy B, Stoll C, Uettwiller F, Oberling F, Bergerat J P
Nouv Rev Fr Hematol (1978). 1982;24(5):307-12.
In 4 cases, the probable diagnosis was that of a chronic myeloid leukaemia (CML) in a blast crisis, because of the sudden acute onset and the presence of the Ph 1 chromosome. In each case, however, there were Auer bodies in the blasts, an unusual finding in CML. Cytological and cytochemical examination led respectively to the diagnosis of an M2 acute myeloblastic leukaemia (AML), according to the FAB classification, to that of a pre-leukaemia progressing to an M2 AML, to that of a M3 promyelocyte leukaemia, with numerous monocytes and finally, in one case, the diagnosis lay between a possible acute crisis of CML with Auer bodies or an acute myelo-monocyte leukaemia. These atypical findings did not conform to the classic picture of CML and cannot be classified as such in spite of the presence of the Ph 1 chromosome. To consider them as true CML would be to run a risk of distorting the haematological evolutive and therapeutic aspects of this disease.
4例患者因急性起病及存在Ph1染色体,初步诊断为慢性粒细胞白血病(CML)急变期。然而,每例患者的原始细胞中均有奥氏小体,这在CML中并不常见。根据FAB分类,细胞形态学和细胞化学检查分别诊断为M2型急性髓系白血病(AML)、进展为M2型AML的白血病前期、伴有大量单核细胞的M3型早幼粒细胞白血病,最后1例患者的诊断介于可能伴有奥氏小体的CML急性变和急性粒-单核细胞白血病之间。这些不典型表现不符合CML的经典特征,尽管存在Ph1染色体,也不能如此分类。将它们视为真正的CML会有扭曲该疾病血液学演变和治疗方面情况的风险。