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Morphologic and cytochemical characteristics of acute promyelocytic leukemia
Author(s) -
Davey F. R.,
Davis R. B.,
Maccallum J. M.,
Nelson D. A.,
Mayer R. J.,
Ball E. D.,
Griffin J. D.,
Schiffer C. A.,
Bloomfield C. D.
Publication year - 1989
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.2830300406
Subject(s) - acute promyelocytic leukemia , gastroenterology , medicine , leukemia , acute leukemia , myeloperoxidase , pathology , biology , inflammation , retinoic acid , cell culture , genetics
The existence of two distinct subtypes of acute promyelocytic leukemia was confirmed and characterized based on morphologic features of leukemic cells in a series of 63 patients studied by the Cancer and Leukemia Group B (CALGB). Seventeen patients (27%) had microgranular leukemic cells (M3V), and 46 patients (73%) had hypergranular leukemic cells (M3). These patient cohorts were studied for other laboratory and clinical features. Leukemic cells from M3V patients stained less frequently than leukemic cells from M3 patients for myeloperoxidase (median, 93% vs. 99%; P =.006), periodic acid‐Schiff (median, 57% vs. 92%; P =.0001), ASD‐chloroacetate esterase (median, 45% vs. 87%; P <.0001), and alpha‐naphthyl acetate esterase (0% vs. 37%; P =.003). Patients with M3V had a higher platelet count (median, 50 vs. 30 × 10 9 /L; P =.01) and tended to have a higher leukocyte count (median, 7.4 vs. 2.2 × 10 9 /L; P =.06) than M3 patients. The patients with M3V morphology were more likely to be nonwhite (29% vs. 7%; P =.03), female (71% vs. 37%; P =.02), and to be infected at the time of presentation (71% vs. 35%; P =.02). No differences in the frequency of the t(15;17) karyotype or the immunopheno‐typic expression of the leukemic cells were noted in the two morphologic subtypes of acute promyelocytic leukemia. Fewer patients with M3V tended to enter complete remission (65% vs. 80%; P =.20), but no significant differences were found in the duration of complete remission ( P =.81; 1 year rate, 50% vs. 85%), or probability of survival ( P =.67; 1 year rate, 49% vs. 68%).