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The development of acute myelomonocytic leukemia in a patient with acute lymphocytic leukemia
Author(s) -
Madoff Leonard,
Davey Frederick R.,
Gordon Gerald B.,
Dock Nancy L.,
Golderg Jack
Publication year - 1981
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19810901)48:5<1157::aid-cncr2820480520>3.0.co;2-h
Subject(s) - lymphoblast , acute myelomonocytic leukemia , bone marrow , sudan black b , medicine , leukemia , pathology , antigen , peroxidase , acute leukemia , null cell , lymphocyte , immunology , acute lymphocytic leukemia , staining , biology , lymphoblastic leukemia , enzyme , biochemistry , cell culture , genetics , gene
A diagnosis of acute lymphocytic leukemia (ALL) was made from a peripheral blood and bone marrow specimen from a 59‐year‐old woman. Typical‐appearing lymphoblasts were positive for periodic acid‐Schiff (PAS) reaction, but negative for peroxidase, Sudan black B (SBB) and non‐specific esterase (NSE) stains. Lymphoblasts failed to form non‐immune rosettes and had no surface membrane immunoglobulins. However, lymphoblasts exhibited an “Ia‐like” membrane antigen and markedly stimulated allogeneic lymphocytes in a mixed lymphocyte reaction (MLR). These cytochemical and immunologic studies were considered characteristic of null‐cell subtype of ALL. Thirteen months later, the peripheral blood and bone marrow specimens contained numerous myelomonoblasts characterized by a weak or negative PAS stain and strongly positive peroxidase, SBB, and NSE reactions. Electron micrographs of the bone marrow suggested that the majority of leukemic cells were myelomonocytic and a minority of cells were lymphoblasts. In addition, myelomonoblasts in liquid cultures appeared to differentiate into mature macrophages. These data suggest the development of acute myelomonocyte leukemia in a previous case of ALL.