Favre G, Passweg J, Hoffmann T, Speck B, Gratwohl A, Tichelli A
Departement Innere Medizin, Kantonsspital Basel.
Schweiz Med Wochenschr. 1998 Oct 17;128(42):1624-6.
The blast crisis in chronic myeloid leukaemia (CML) is morphologically well defined. The aim of this report was to analyze whether immunophenotyping can divide CML blast crises into subtypes as is done in acute de novo leukaemia, and whether a specific CML pattern exists. Between 1991 and 1997 we reevaluated all the immunophenotypes of patients with CML blast crises with special regard to immunological subclassification, expression of CD34, presence of aberrant markers and number of immunological clusters. Twenty-nine CML blast crises were analyzed. Seventeen were myeloid, 11 lymphoid and one biphenotypic. The blast crises were divided into subtypes as de novo acute leukaemias: of the 17 myeloid blast crises 6 were undifferentiated, 5 differentiated and 6 had monocytic differentiation. In the lymphoid blast crises there were no pro-B, 8 common-B and 3 mature-B. No T-lymphoid blast crises were observed. In 26/29 analyses (90%) CD34 was expressed in the blasts. In 17/29 analyses (59%) one or two aberrant markers were found. In summary, immunophenotyping is important in distinguishing between myeloid and lymphoid blast crises. A subclassification, as in acute leukaemias, is possible. We found no specific immunophenotypic CML pattern. A study directly comparing immunophenotyping of CML blast crises with acute de novo leukaemia is planned.
慢性粒细胞白血病（CML）的急变期在形态学上有明确的定义。本报告的目的是分析免疫表型分型是否能像在原发性急性白血病中那样，将CML急变期分为不同亚型，以及是否存在特定的CML模式。在1991年至1997年间，我们重新评估了所有CML急变期患者的免疫表型，特别关注免疫学分型、CD34的表达、异常标志物的存在以及免疫簇的数量。对29例CML急变期进行了分析。其中17例为髓系，11例为淋系，1例为双表型。急变期像原发性急性白血病一样被分为不同亚型：在17例髓系急变期中，6例为未分化型，5例为分化型，6例有单核细胞分化。在淋系急变期中，没有前B细胞型，8例为普通B细胞型，3例为成熟B细胞型。未观察到T淋巴细胞急变期。在26/29例分析（90%）中，原始细胞表达CD34。在17/29例分析（59%）中发现了一种或两种异常标志物。总之，免疫表型分型对于区分髓系和淋系急变期很重要。像在急性白血病中一样进行亚分类是可行
