Yamagata T, Miwa A, Eguchi M, Kitagawa S, Muroi K, Hatake K, Suda T, Sakamoto S, Miura Y
Department of Medicine, Jichi Medical School, Tochigi-ken, Japan.
Br J Haematol. 1995 Mar;89(3):650-2. doi: 10.1111/j.1365-2141.1995.tb08381.x.
We describe a patient with basophilic leukaemia following a 2-year period with myelodysplastic syndrome (refractory anaemia). The marrow showed 59.4% of blasts with 25.0% of mature and immature basophils. The leukaemic blasts contained granules, positively stained with toluidine blue but negative for peroxidase. The basophilic differentiation was confirmed by ultrastructural analysis demonstrating immature basophil granules. In addition, a morphological transition from immature blasts to more mature basophils was observed. Immunophenotypic analysis of blasts and basophils showed positive for CD5, CD7, CD13, CD33 and CD34. Cytogenetic investigation showed an abnormal karyotype, 46,XY,del(5)(q31q35), in 11% of the cells examined when the initial diagnosis of refractory anaemia was made. However, expansion of the same clone up to 100% was observed concomitantly with transformation to basophilic leukaemia.
我们描述了一名患有嗜碱性粒细胞白血病的患者，其在出现骨髓增生异常综合征（难治性贫血）两年后发病。骨髓中原始细胞占59.4%，成熟和未成熟嗜碱性粒细胞占25.0%。白血病原始细胞含有颗粒，甲苯胺蓝染色呈阳性，但过氧化物酶染色呈阴性。超微结构分析证实了嗜碱性粒细胞分化，显示存在未成熟的嗜碱性粒细胞颗粒。此外，还观察到从原始未成熟细胞到更成熟嗜碱性粒细胞的形态学转变。对原始细胞和嗜碱性粒细胞的免疫表型分析显示，CD5、CD7、CD13、CD33和CD34呈阳性。细胞遗传学研究显示，在难治性贫血初诊时，所检测的11%的细胞中存在异常核型46,XY,del(5)(q31q35)。然而，在向嗜碱性粒细胞白血病转化的同时，观察到同一克隆扩增至100%。
