Lemez P, Michalová K, Jelínek J, Janousek J, Marinov I, Burjanková J, Skuhrovcová I, Rysková P
Ustav hematologie a krevní transfuze, Praha.
Cas Lek Cesk. 1994 Nov 21;133(22):702-5.
Acute myeloid leukemias (AML) are a heterogeneous group of diseases, several types of them are well characterized by typical morphologic, immunologic and cytogenetic features of their leukemic blasts in the MIC classification. We have recently described 2 patients with a new AML type--poorly differentiated near-tetraploid AML L0. The occurrence of very large blasts in a heterogeneous blast population seemed to be a morphological sign of this new type of AML.
The same morphologic characteristics were observed by us when we studied blasts of another 80-year-old patient with a near-tetraploid karyotype. However, 34% of blasts were positive for myeloperoxidase and they exhibited in 24-33% surface myelomonocytic markers CD11b, CD13, CD15 and CD14. The illness was classified as acute myelomonoblastic leukemia M4 without significant dysplastic changes in erythroid and megakaryocytic lineages. The growth of granulocyte-macrophage bone marrow progenitors CFU-GM was low. The patient refused cytotoxic chemotherapy and expired 3 months later on supportive treatment.
The finding of very large blasts is a typical sign in cases of near-tetraploid AML. Precise classification of leukemia type is essential for successful therapy.
急性髓系白血病（AML）是一组异质性疾病，其中几种类型在MIC分类中通过其白血病原始细胞的典型形态、免疫和细胞遗传学特征得到了很好的表征。我们最近描述了2例新的AML类型患者——低分化近四倍体AML L0。在异质性原始细胞群体中出现非常大的原始细胞似乎是这种新型AML的一个形态学标志。
当我们研究另一名80岁近四倍体核型患者的原始细胞时，观察到了相同的形态学特征。然而，34%的原始细胞髓过氧化物酶呈阳性，并且它们在24% - 33%的细胞表面表达髓单核细胞标志物CD11b、CD13、CD15和CD14。该疾病被归类为急性粒单核细胞白血病M4，红系和巨核系无明显发育异常改变。粒细胞 - 巨噬细胞骨髓祖细胞CFU - GM的生长较低。患者拒绝接受细胞毒性化疗，3个月后在支持治疗中死亡。
发现非常大的原始细胞是近四倍体AML病例中的一个典型标志。准确分类白血病类型对于成功治疗至关重要。
