1例近四倍体急性髓系白血病的临床特点分析

doi:10.3969/j.issn.1673-8640.2017.07.022

检验医学 ›› 2017, Vol. 32 ›› Issue (7): 652-655.DOI: 10.3969/j.issn.1673-8640.2017.07.022

1例近四倍体急性髓系白血病的临床特点分析

朱建锋, 王蓓丽, 郭玮, 潘柏申

复旦大学附属中山医院检验科,上海 200032

收稿日期:2017-03-02 出版日期:2017-08-08 发布日期:2017-08-09
作者简介:null
作者简介：朱建锋,男,1977年生,主管技师,主要从事外周血与骨髓细胞形态学检查工作。
基金资助:
基金项目：国家自然科学基金面上项目（81572064）;上海市卫生计生系统重要薄弱学科建设项目（2015ZB0201）

Clinical characteristics of a case of near-tetraploidy acute myeloid leukemia

ZHU Jianfeng, WANG Beili, GUO Wei, PAN Baishen

Department of Clinical Laboratory,Zhongshan Hospital,Fudan University,Shanghai 200032,China

Received:2017-03-02 Online:2017-08-08 Published:2017-08-09

摘要/Abstract

摘要：

目的报道1例近四倍型急性髓系白血病（NT-AML）,通过文献复习进一步分析NT-AML的临床、形态学、细胞遗传学特点及预后。方法对1例形态异常的NT-AML 从形态学、免疫表型、治疗与预后等方面进行评估。形态特征包括细胞核大小、核形状、胞浆空泡、颗粒和发育不良情况。结果该病例染色体分析显示近四倍体核型。免疫分型符合髓系白血病表型,无淋系抗原表达。形态学上近四倍体原始细胞体积增大,出现胞浆颗粒显著增多,似异常早幼粒细胞。同时粒细胞形态伴有骨髓增生异常相关的改变。结论 NT-AML主要发生于老年男性,常以原始细胞体积增大和骨髓造血发育不良为特点。患者存在造血发育异常及复杂核型,缓解率与生存时间短,近四倍体核型可作为总体生存率不良预后的标志。

关键词: 急性髓系白血病, 近四倍体核型, 形态学特点, 预后

Abstract:

：Objective To report a case of near-tetraploidy acute myeloid leukemia（NT-AML）,and to analyze its clinical,morphological and cytogenetic characteristics. Methods A case of NT-AML was reported,and its morphology,immunophenotype,treatment and prognosis were evaluated. Morphological characteristics included blast size,irregularity of nuclear contours,cytoplasmic vacuoles,granules and dysplasia. Results This case described acute myeloid leukemia with a near-tetraploid karyotype. Immunophenotype of blasts was consistent with myeloid leukemia phenotype,without expressing lymphoid marker. Blasts were characterized by hyper-granule in cytoplasm,resembling abnormal promyelocytes. It was also showed myelodysplasia-related morphologic changes in myeloid lineages. Conclusions NT-AML occurs in elder males,which exhibits large blast size and is associated with myelodysplasia. It is typically associated with a poor treatment response,low complete remission and short survival. Near-tetraploid karyotype could be used as a sign of poor prognosis with low survival.

Key words: Acute myeloid leukemia, Near-tetraploidy karyotype, Morphological characteristic, Prognosis

中图分类号:

R446.1

朱建锋, 王蓓丽, 郭玮, 潘柏申. 1例近四倍体急性髓系白血病的临床特点分析[J]. 检验医学, 2017, 32(7): 652-655.

ZHU Jianfeng, WANG Beili, GUO Wei, PAN Baishen. Clinical characteristics of a case of near-tetraploidy acute myeloid leukemia[J]. Laboratory Medicine, 2017, 32(7): 652-655.

图/表 3

参考文献 10

[1]	VARDIMAN J W,THIELE J,ARBER D A,et al.The 2008 revision of the World Health Organization(WHO)classification of myeloid neoplasms and acute leukemia:rationale and important changes[J]. Blood,2009,114(5):937-951.
[2]	ABE R,RAZA A,PREISLER H D,et al.Chromosomes and causation of human cancer and leukemia. LIV. Near-tetraploidy in acute leukemia[J]. Cancer Genet Cytogenet,1985,14(1-2):45-59.
[3]	CLARKE M R,LYNCH E F,CONTIS L C,et al.Near-tetraploidy in adult acute myelogenous leukemia[J]. Cancer Genet Cytogenet,1996,86(2):107-115.
[4]	PANG C S,PETTENATI M J,PARDEE T S.Clinicopathological analysis of near-tetraploidy/tetraploidy acute myeloid leukaemia[J]. J Clin Pathol,2015,68(3):236-240.
[5]	LISO V,BENNETT J.Morphological and cytochemical characteristics of leukaemic promyelocytes[J]. Best Pract Res Clin Haematol,2003,16(3):349-355.
[6]	AU W Y,MA S K,LAM C C,et al.Tetraploid acute promyelocytic leukemia with large bizarre blast cell morphology[J]. Cancer Genet Cytogenet,1999,115(1):52-55.
[7]	IYER R V,SAIT S N,MATSUI S,et al.Massive hyperdiploidy and tetraploidy in acute myelocytic leukemia and myelodysplastic syndrome[J]. Cancer Genet Cytogenet,2004,148(1):29-34.
[8]	LEMEZ P,GALIKOVA J,HAAS T.Erythroblastic and/or megakaryocytic dysplasia in de novo acute myeloid leukemias M0-M5 show relation to myelodysplastic syndromes and delimit two main categories[J]. Leuk Res,2000,24(3):207-215.
[9]	BÉNÉ M C,CASTOLDI G,DEROLF A,et al. Near-tetraploid acute myeloid leukemias:an EGIL retrospective study of 25 cases[J]. Leukemia,2006,20(4):725-728.
[10]	HUANG L,WANG S A,DINARDO C,et al.Tetraploidy/near-tetraploidy acute myeloid leukemia[J]. Leuk Res,2017,53:20-27.

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1例近四倍体急性髓系白血病的临床特点分析

Clinical characteristics of a case of near-tetraploidy acute myeloid leukemia

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