Jackson C W, Dahl G V
Blood. 1983 May;61(5):867-70.
Small megakaryocytes are frequently seen in patients with acute nonlymphocytic leukemia (ANLL). In this study, median megakaryocyte diameters were determined in marrow biopsy specimens of 32 children at diagnosis of ANLL and related to platelet count and chemotherapeutic response. The association between median megakaryocyte size and time-to-failure was striking. Seven of 9 patients with median megakaryocyte diameters greater than 20 microns remain in continuous complete remission for more than 3 yr, whereas 20 of 23 patients with smaller median megakaryocyte diameters failed therapy within 15 mo (p = 0.002). By Cox-regression analysis, megakaryocyte size had independent prognostic value (p less than 0.001), surpassing that of spleen size, the only other feature having significant association with time-to-failure. Megakaryocyte size at diagnosis may be useful for predicting the likelihood of prolonged complete remission in ANLL.
小巨核细胞在急性非淋巴细胞白血病（ANLL）患者中经常可见。在本研究中，测定了32例ANLL患儿诊断时骨髓活检标本中巨核细胞的中位直径，并将其与血小板计数和化疗反应相关联。中位巨核细胞大小与治疗失败时间之间的关联十分显著。9例中位巨核细胞直径大于20微米的患者中有7例持续完全缓解超过3年，而23例中位巨核细胞直径较小的患者中有20例在15个月内治疗失败（p = 0.002）。通过Cox回归分析，巨核细胞大小具有独立的预后价值（p < 0.001），超过了脾脏大小，脾脏大小是唯一与治疗失败时间有显著关联的其他特征。诊断时的巨核细胞大小可能有助于预测ANLL患者长期完全缓解的可能性。
