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  • Title: [Analysis on the laboratory examination characteristics in 22 patients with acute megakaryoblastic leukemia].
    Author: Dong S, Zhao S, Wang Y, Cui W, Li C, Chen Y, Zhu X, Mi Y, Ru Y, Wang J.
    Journal: Zhonghua Xue Ye Xue Za Zhi; 2016 Apr; 37(4):297-301. PubMed ID: 27093992.
    Abstract:
    OBJECTIVE: To analyze the ultra microstructures and the expression of platelet peroxidase (PPO) of megakaryocytes from bone marrow, their clinical manifestations and laboratory characteristics in patients with acute megakaryoblastic leukemia (AMKL). METHODS: Karyocytes from bone marrow of 22 AMKL patients were divided into two parts by lymphocyte separation liquid, one part was used to prepare the ordinary transmission electron microscope specimens to observe the morphological structures of megakaryocytes, the other was used to prepare the histochemical specimens of platelet peroxidase to analyze the positive reaction of PPO in AMKL, which were coupled with the patients' data of with bone marrow morphology, cell chemistry, and chromosome karyotype examination. RESULTS: Megakaryocytes from 17 of 22 patients were in the first stage, less than 20 µm in diameter, the nucleis were round, the cytoplasm contained microtubules, membranous vesicles and minute dense granules, no demarcation membrane system and surface-connected canalicular system, less dense granules and α-granules; Megakaryocytes in 5 cases were mainly in the first stage, while containing second and third stage megakaryocytes; the positive rate of PPO in megakaryocytes of 22 patients was 0-80%. The primitive and naive megakaryocytes were found in bone marrow smears of 22 cases, CD41 staining of the megakaryocytes was detected in the primitive and naive megakaryocytes, and more complex chromosome karyotype anomalies were observed. CONCLUSION: The majority of megakaryocytes in AMKL patients were the first stage ones, the rest were second and third stage ones, and the positive PPO reaction was significantly different. CD41 staining of the megakaryocytes was specific with complex chromosome karyotypeswere. 目的: 分析急性巨核细胞白血病（AMKL）患者实验室检查特点。 方法: 采集22例AMKL患者骨髓，分离有核细胞，一部分用于制备普通透射电镜标本，观察AMKL患者巨核细胞的形态结构；另一部分用于制备血小板过氧化物酶（PPO）细胞组化电镜标本，分析AMKL患者巨核细胞PPO阳性反应。同时结合分析患者骨髓细胞形态学、细胞化学和染色体核型等检查结果。 结果: 22例患者中，17例患者骨髓巨核细胞以Ⅰ期巨核细胞为主，核圆，胞质含少量微管、膜性囊腔及微小致密颗粒，无分界膜和表面连接管道系统等特征性结构，致密颗粒和α颗粒少；5例患者骨髓巨核细胞大小不等，除Ⅰ期巨核细胞外，同时含有大量Ⅱ、Ⅲ期巨核细胞。22例患者巨核细胞PPO阳性率0~80%。22例患者骨髓涂片中均可见原始和幼稚巨核细胞，CD41免疫组化染色呈阳性反应。复杂染色体核型异常多见。 结论: 大部分AMKL患者骨髓巨核细胞以Ⅰ期巨核细胞为主，少数患者除Ⅰ期巨核细胞外还伴有大量Ⅱ、Ⅲ期巨核细胞；PPO阳性反应差别明显；巨核细胞CD41免疫组化染色具有特异性；染色体核型复杂。
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