Ultrastructural studies of the megakaryoblastic leukemias of Down syndrome.

The ultrastructure of the leukemic cells in transient leukemia (six cases), myelodysplasia (five cases) and acute megakaryoblastic leukemia (one case) in patients with Down syndrome were studied. The cells were identified to be of megakaryocytic lineage by virtue of the expression of platelet glycoprotein GpIIIa, detected by immunogold labelling. In all patients, some of the leukemic cells had ultrastructural features of megakaryocytes, including ectoplasmic protrusions, demarcation membranes, and alpha granules. Differentiation was greatest in the cells of patients with transient leukemia. These studies provide a detailed assessment of the ultrastructural features of the leukemic cells in the megakaryoblastic leukemias of Down syndrome.