Cuttner J, Conjalka M S, Reilly M, Goldberg J, Reisman A, Meyer R J, Holland J F
Am J Med. 1980 Oct;69(4):555-8. doi: 10.1016/0002-9343(80)90467-2.
Fifteen of 73 newly diagnosed patients with acute myeloid leukemia (AML), admitted to Mount Sinai Hospital between July 1977 and October 1979, presented with leukocyte counts greater than 100,000/microliter. Eleven of these 15 patients with hyperleukocytosis had myelomonocytic (AMML-M4) or monocytic (AMOL-M5) leukemia compared to 15 of 58 patients with lower white cell counts (p < 0.001). Identification of type of leukemia, using the FAB classification, was based on morphology and special stains, including myeloperoxidase, Sudan black B, periodic acid-Schiff and nonspecific esterase with and without inhibition by fluoride. The proportion of patients with splenomegaly is higher in those with hyperleukocytosis (73 percent) than in those with lower white blood cell counts (p < 0.001) regardless of cell type. Leukemic infiltration of the skin, gums and central nervous system was seen exclusively in patients with AMML and AMOL. The serum lysozyme levels were significantly higher for all patients with AMML and AMOL regardless of the white blood cell count. The mean serum lysozyme for M-4, M-5 patients was 59.7 microgram/ml compared to 18.9 microgram/ml in patients with other cell types (p < 0.0001). Patients with a white blood cell count less than or equal to 100,000/microliter had a complete remission rate of 69 percent compared to 47 percent for patients with higher white blood cell counts.
1977年7月至1979年10月期间，西奈山医院收治了73例新诊断的急性髓系白血病（AML）患者，其中15例白细胞计数超过100,000/微升。这15例白细胞增多症患者中，11例患有骨髓单核细胞白血病（AMML-M4）或单核细胞白血病（AMOL-M5），而白细胞计数较低的58例患者中有15例患有此类白血病（p<0.001）。采用FAB分类法确定白血病类型，依据形态学和特殊染色，包括髓过氧化物酶、苏丹黑B、过碘酸希夫反应以及有无氟化钠抑制的非特异性酯酶。无论细胞类型如何，白细胞增多症患者的脾肿大比例（73%）高于白细胞计数较低的患者（p<0.001）。皮肤、牙龈和中枢神经系统的白血病浸润仅见于AMML和AMOL患者。无论白细胞计数如何，所有AMML和AMOL患者的血清溶菌酶水平均显著升高。M-4、M-5患者的平均血清溶菌酶为59.7微克/毫升，而其他细胞类型患者为18.9微克/毫升（p<0.0001）。白细胞计数小于或等于100,000/微升的患者完全缓解率为69%，而白细胞计数较高的患者为47%。
