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Diagnostic and prognostic factors in acute monocytic leukaemia: an analysis of 51 cases
Author(s) -
Scott Colin Stephen,
Stark Allistair N.,
Limbert Howard J.,
Master Peter S.,
Head Christine,
Roberts Bryon E.
Publication year - 1988
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1988.tb07629.x
Subject(s) - cytochemistry , immunophenotyping , staining , acute monocytic leukemia , cd14 , biology , medicine , beta 2 microglobulin , pathology , leukemia , immunology , gastroenterology , antigen , enzyme , biochemistry , flow cytometry
Summary. Diagnostic features (cytochemistry, immunophenotyping and serum biochemistry) were examined in 51 cases of acute monocytic leukaemia (AMoL). Peroxidase, Sudan black B and alpha naphthyl acetate esterase (ANAE) cytochemical reactions were unrelated to morphological (FAB groups M5a and M5b) or immunological subtype. ANAE cytochemistry, however, indicated that AMoL cases could be subdivided into those with typical (M‐type) reactions and those with insignificant staining or monocytic ANAE isoenzymes (defined by IEF). All cases were phenotypically CD13/CD33 positive and, with one exception, had > 30% HLA‐DR positive cells. Membrane CD14 expression was insignificant or variable in 33% of M5a cases in contrast to 23/24 M5b cases which showed high proportions of CD14‐staining cells with at least two monoclonal antibodies. Serum lysozyme, LDH and beta‐2 microglobulin (β 2 m) were increased in 88%, 68% and 81% of cases respectively but, with the exception of statistically higher lysozyme levels in CD14 + cases, were unrelated to the morphological, cytochemical or immunological diagnostic subgroups. Clinical and diagnostic features were also examined as possible prognostic indicators. The morphological, cytochemical and immunological subgroups of AMoL were not found to be of prognostic relevance but age ( P =0.004), renal failure ( P =0.005) and serum β 2 m levels ( P =0.002) were related to patient survival. Moreover, renal failure and serum β 2 m remained significant ( P =0.012 respectively) when age was taken into account and were shown to be independent prognostic variables.