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Leonhardt L, Harcha J, Calvo A. Gingival overgrowth in acute monocytic leukemia. Cleve Clin J Med 2024; 91:267-268. [PMID: 38692700 DOI: 10.3949/ccjm.91a.23087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Affiliation(s)
- Lex Leonhardt
- Department of Hematology Oncology Fellowship, Kettering Medical Center, Kettering, OH
| | - John Harcha
- Department of Hematology Oncology Fellowship, Kettering Medical Center, Kettering, OH
| | - Alejandro Calvo
- Department of Hematology Oncology Fellowship, Kettering Medical Center, Kettering, OH
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2
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Podvin B, Soenen V, Dumezy F, Herlem J, Berthon C, Guermouche H, Thibaud V, Pascal L, Duployez N, Charpentier A. A new combination of monocytic scores to support diagnosis of chronic myelomonocytic leukemia according to novel classifications. Int J Lab Hematol 2023; 45:791-794. [PMID: 36967295 DOI: 10.1111/ijlh.14067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/04/2023] [Indexed: 03/29/2023]
Affiliation(s)
- Benjamin Podvin
- Laboratory of Hematology, CHU Lille, Lille, France
- Laboratory of Hematology, Hospital Group of Lille Catholic University, Lille, France
| | | | | | - Julien Herlem
- Laboratory of Hematology, Hospital Group of Lille Catholic University, Lille, France
| | - Céline Berthon
- CHU Lille, Department of Hematology, Huriez Hospital, Lille, France
| | | | - Vincent Thibaud
- Hematology Department, Hospital Group of Lille Catholic University, Lille, France
| | - Laurent Pascal
- Hematology Department, Hospital Group of Lille Catholic University, Lille, France
| | - Nicolas Duployez
- Laboratory of Hematology, CHU Lille, Lille, France
- Plasticity and Resistance to Therapies, Univ. Lille, CNRS, Inserm, CHU Lille, IRCL, UMR9020-UMR1277-Canther-Cancer Heterogeneity, Lille, France
| | - Agnès Charpentier
- Laboratory of Hematology, Hospital Group of Lille Catholic University, Lille, France
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3
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Fujita T, Fukushima H, Nanmoku T, Arakawa Y, Deguchi T, Suzuki R, Yamaki Y, Hosaka S, Takada H. Acute monocytic leukemia with KMT2A::LASP1 developed 9 months after diagnosis of acute megakaryoblastic leukemia in a 2-year-old boy. Int J Hematol 2023; 118:514-518. [PMID: 37314622 DOI: 10.1007/s12185-023-03622-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 06/15/2023]
Abstract
Acute myeloid leukemia (AML) is known as one of the subsequent malignant neoplasms that can develop after cancer treatment, but it is difficult to distinguish from relapse when the preceding cancer is leukemia. We report a 2-year-old boy who developed acute megakaryoblastic leukemia (AMKL, French-American-British classification [FAB]: M7) at 18 months of age and achieved complete remission with multi-agent chemotherapy without hematopoietic stem cell transplantation. Nine months after diagnosis and 4 months after completing treatment for AMKL, he developed acute monocytic leukemia (AMoL) with the KMT2A::LASP1 chimeric gene (FAB: M5b). The second complete remission was achieved using multi-agent chemotherapy and he underwent cord blood transplantation 4 months after AMoL was diagnosed. He is currently alive and disease free at 39 and 48 months since his AMoL and AMKL diagnoses, respectively. Retrospective analysis revealed that the KMT2A::LASP1 chimeric gene was detected 4 months after diagnosis of AMKL. Common somatic mutations were not detected in AMKL or AMoL and no germline pathogenic variants were detected. Since the patient's AMoL was different from his primary leukemia of AMKL in terms of morphological, genomic, and molecular analysis, we concluded that he developed a subsequent leukemia rather than a relapse of his primary leukemia.
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MESH Headings
- Child, Preschool
- Humans
- Male
- Adaptor Proteins, Signal Transducing
- Cytoskeletal Proteins
- Leukemia, Megakaryoblastic, Acute/diagnosis
- Leukemia, Megakaryoblastic, Acute/genetics
- Leukemia, Megakaryoblastic, Acute/therapy
- Leukemia, Monocytic, Acute/diagnosis
- Leukemia, Monocytic, Acute/genetics
- Leukemia, Monocytic, Acute/therapy
- LIM Domain Proteins
- Recurrence
- Remission Induction
- Retrospective Studies
- Histone-Lysine N-Methyltransferase/genetics
- Oncogene Proteins, Fusion/genetics
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Affiliation(s)
- Takashi Fujita
- Department of, Pediatrics, University of Tsukuba Hospital, Tsukuba, Japan
| | - Hiroko Fukushima
- Department of, Pediatrics, University of Tsukuba Hospital, Tsukuba, Japan.
- Department of Child Health, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Toru Nanmoku
- Department of Clinical Laboratory, University of Tsukuba Hospital, Tsukuba, Japan
| | - Yuki Arakawa
- Department of Hematology and Oncology, Saitama Children's Medical Center, Saitama, Japan
| | - Takao Deguchi
- Division of Cancer Immunodiagnostics, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Ryoko Suzuki
- Department of, Pediatrics, University of Tsukuba Hospital, Tsukuba, Japan
- Department of Child Health, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Yuni Yamaki
- Department of, Pediatrics, University of Tsukuba Hospital, Tsukuba, Japan
| | - Sho Hosaka
- Department of, Pediatrics, University of Tsukuba Hospital, Tsukuba, Japan
| | - Hidetoshi Takada
- Department of, Pediatrics, University of Tsukuba Hospital, Tsukuba, Japan
- Department of Child Health, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
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4
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Mandal AP, Das R, Sengupta M, Chatterjee U. Leukemia cutis - A case of cutaneous manifestation of acute monoblastic leukemia. J Cancer Res Ther 2023; 19:826-828. [PMID: 37470620 DOI: 10.4103/jcrt.jcrt_350_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
Leukemia cutis is a comprehensive terminology for dermal manifestations of any type of leukemia either with accompanied or antecedent blood or bone marrow involvement. Although both myeloid and lymphoid neoplastic leukocytes can infiltrate the skin, the frequency is higher among children with congenital myeloid leukemia. However, the underlying pathogenesis of dermal tropism is not yet established. Clinical manifestation varies regarding appearance, site, and numbers. Skin biopsy is essential for the early establishment of the diagnosis and to guide for further testing and categorical management. We report the case of acute myeloid leukemia-cutis in a 22-year-old female where cutaneous manifestation preceded the hematological diagnosis of systemic leukemia.
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MESH Headings
- Female
- Child
- Humans
- Young Adult
- Adult
- Leukemia, Monocytic, Acute/complications
- Leukemia, Monocytic, Acute/diagnosis
- Leukemia, Monocytic, Acute/pathology
- Skin Neoplasms/diagnosis
- Skin Neoplasms/pathology
- Leukemia, Myeloid, Acute/complications
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/pathology
- Skin/pathology
- Biopsy
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Affiliation(s)
| | - Rhituparna Das
- Department of Pathology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
| | - Moumita Sengupta
- Department of Pathology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
| | - Uttara Chatterjee
- Department of Pathology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
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5
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Scoville NM, Feng S, Taylor MR, Herlihy E, Wilkes JJ, Chisholm KM, Tarczy-Hornoch K. Bilateral Pseudo-hypopyon as Presenting Symptom of Acute Monocytic Leukemia in an 8-Month-Old Infant. J Pediatr Ophthalmol Strabismus 2021; 58:e30-e33. [PMID: 34592122 DOI: 10.3928/01913913-20210708-05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A previously healthy 8-month-old female infant presenting with lethargy and bilateral eye redness and cloudiness had bilateral hypopyon uveitis, which persisted despite topical steroids. Cytology of the anterior chamber and cerebrospinal fluid and flow cytometry of cerebrospinal fluid revealed malignant cells consistent with acute monocytic leukemia. Bone marrow aspirates and biopsies showed no evidence of disease. She was treated with systemic and intrathecal chemotherapy, with subsequent remission and resolution of pseudo-hypopyon. Anterior chamber involvement is a rare presentation of acute myeloid leukemia and may indicate concurrent central nervous system involvement. This has important therapeutic implications, because additional treatment modalities such as intrathecal chemotherapy, local chemotherapy, and ocular radiation may be required to overcome the "pharmacologic sanctuary" created by the blood-ocular barrier. [J Pediatr Ophthalmol Strabismus. 2021;58(5):e30-e33.].
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Kamili NA, Morrison CE, Bagg A, Westheim A, Hafeez F. Leukemia Cutis With Histopathologic and Immunophenotypic Features Resembling S100-Negative CD1a-Positive Cutaneous Histiocytosis. Am J Dermatopathol 2021; 43:574-575. [PMID: 33298709 DOI: 10.1097/dad.0000000000001868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT S100-negative CD1a-positive cutaneous histiocytosis is an exceedingly rare histiocytosis that is defined histopathologically by a dense dermal infiltrate of ovoid mononuclear cells with grooved nuclei and ample cytoplasm with variable nuclear atypia and mitoses that are immunohistochemically positive for CD1a and negative for S100 and CD207 (langerin). The histogenesis of S100-negative CD1a-positive histiocytosis is unclear, and its precursor cell has yet to be characterized. Although all cases thus far have been described as benign and occasionally self-resolving, the clinical course and outcome of this disease are not fully understood. This case expands the spectrum of disease associated with S100-negative CD1a-positive histiocytosis given its malignant course.
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Affiliation(s)
- Nourine A Kamili
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA
| | - Casey E Morrison
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA; and
| | - Adam Bagg
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA; and
| | - Alan Westheim
- Department of Dermatology, St. Luke's University Health System, St. Luke's/Temple School of Medicine, Bethlehem, PA
| | - Farhaan Hafeez
- Department of Dermatology, St. Luke's University Health System, St. Luke's/Temple School of Medicine, Bethlehem, PA
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7
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Chen X, Liu K, Hu J, Fan J, Huo Q, Yin J. Rare Case of Diffuse Large B-Cell Lymphoma Mimicking Acute Monocytic Leukemia, Associated with Complex Karyotype. Ann Clin Lab Sci 2020; 50:397-400. [PMID: 32581033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Diffuse Large B-Cell Lymphoma (DLBCL), NOS, constitutes 25-35% of adult non-Hodgkin lymphomas in developed countries, and a higher percentage in developing countries; older people are prone to the disease. Three frequent morphological variants have been recognized, including centroblastic, immunoblastic, and anaplastic variants. However, there are still other rare morphological variants of DLBCL, presenting challenge in diagnosis and treatment. CASE PRESENTATION A 62-year-old woman sought medical attention with a previous 6-month history of intermittent fever and leukocytosis. Bone marrow (BM) aspiration presented AML with acute monocytic leukemia-like morphologic features. The results of the immunophenotypic analysis suggested mature B cell lymphoma without obvious subtype characteristics. Lymph node biopsy indicated DLBCL of non-germinal centre B-cell subtype (n-GCB). Cytogenetic analysis of the BM cells revealed a 46,XX, trp(1)(q21q32),del(7)(q32q36),t(9;14)(p13;q32) [4]/46,XX [16] karyotype. The patient was diagnosed with EBV-positive DLBCL, NOS based on the combination of lymph node biopsy, clinical, cytological, immunophenotypic, and cytogenetic analyses. CONCLUSION To date, no case reports of a patient diagnosed with DLBCL mimicking acute monocytic leukemia with complex karyotype have been reported. We present the case given its rarity, easy misdiagnosis, and poor prognosis. The case highlights the importance of awareness about the rare morphological variant to laboratory staff and hematologists.
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Affiliation(s)
- Xueyan Chen
- Department of Clinical Laboratory, The People's Hospital of Longhua, Shenzhen, Guangdong Province, China
| | - Keyu Liu
- Department of Clinical Laboratory, Affiliated Hospital of Engineering University of Hebei, Handan, Hebei Province, China
| | - Jintian Hu
- Department of Clinical Laboratory, Affiliated Hospital of Engineering University of Hebei, Handan, Hebei Province, China
| | - Jie Fan
- Department of Clinical Laboratory, Affiliated Hospital of Engineering University of Hebei, Handan, Hebei Province, China
| | - Qingyan Huo
- Department of Clinical Laboratory, Affiliated Hospital of Engineering University of Hebei, Handan, Hebei Province, China
| | - Junping Yin
- Department of Clinical Laboratory, Affiliated Hospital of Engineering University of Hebei, Handan, Hebei Province, China
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8
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Qian J, Shen Q, Yin H, Shi WY, Yang L, Zhang YP, Liu H. Development of myelofibrosis and acute monocytic leukemia in a patient with hereditary spherocytosis: A case report. Medicine (Baltimore) 2019; 98:e18266. [PMID: 31852097 PMCID: PMC6922592 DOI: 10.1097/md.0000000000018266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Common symptoms of hereditary spherocytosis (HS) include intermittent jaundice and splenomegaly. Here, we present an unusual clinical course wherein a patient with HS treated with splenectomy developed secondary myelofibrosis and acute monocytic leukemia (M5). PATIENT CONCERNS After presenting with paleness, fatigue and jaundice, the patient was diagnosed with HS. After splenectomy, follow-up testing, including bone marrow biopsy, revealed myelofibrosis. Subsequently, the patient exhibited blood cell abnormalities consistent with M5. DIAGNOSIS M5 comorbid with myelofibrosis and a history of HS. INTERVENTIONS HS was treated with splenectomy. Myelofibrosis was treated with hydroxyurea. The patient refused chemotherapy for M5 and was discharged. He was maintained on hydroxyurea and received periodic blood product transfusions with regular routine blood test monitoring. OUTCOMES Because of intracranial hemorrhage, the patient died on May 17, 2018, a little >10 months after being diagnosed with leukemia. CONCLUSION The present patient developed M5 while undergoing treatment for myelofibrosis and after undergoing splenectomy for HS, raising the question of whether these conditions might be associated. Examination of this question will require the analysis of additional cases.
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Affiliation(s)
- Juan Qian
- Department of Hematology, Affiliated Hospital of Nantong University
| | - Qian Shen
- Department of Oncology, Nantong Oncology Hospital, Nantong, Jiangsu, China
| | - Hong Yin
- Department of Hematology, Affiliated Hospital of Nantong University
| | - Wen-yu Shi
- Department of Hematology, Affiliated Hospital of Nantong University
| | - Li Yang
- Department of Hematology, Affiliated Hospital of Nantong University
| | - Ya-ping Zhang
- Department of Hematology, Affiliated Hospital of Nantong University
| | - Hong Liu
- Department of Hematology, Affiliated Hospital of Nantong University
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9
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Abstract
We report a case of leukemic arthritis (LA) of monocytic differentiation, which presented with spondyloarthritis-like symptoms and a positive human leukocyte antigen-B27, and discuss its potential mechanisms.The patient was admitted because of pain in her right knee and lower back for 18 months. Magnetic resonance imaging showed diffuse hyperintense signal in the bilateral liac bones and bone marrow edema and synovitis in the right knee.The diagnosis of acute monocytic leukemia and LA were concluded by bone marrow aspiration and flow cytometry of the synovial fluid.The patient had poor response to nonsteroidal anti-inflammatory drugs. One week after she received chemotherapy, the symptoms were dramatically relieved.For 5-year follow-up, she got clinical remission without suffering pain of the right knee and the lower back.Leukemic arthritis is a rare manifestation of leukemia with unknown mechanism and may be the initial presentation of leukemia. The problem whether abnormal immune response of the neoplasitc monocytes together with hereditary factors contribute to the pathogenesis of LA in adult is raised from this case, which worth further research.
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10
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Abstract
We studied an adult with de novo acute monocytic leukemia and a dismal outcome where her leukemic cells harbored an acquired rare jumping translocation (JT). We used oligo-based array CGH (oaCGH) analysis, fluorescence in situ hybridization (FISH), and 24-color karyotyping to enhance the characterization of the JT. G-banding detected a JT involving the 3q13.3-qter chromosomal segment and the recipient chromosomal regions 17p, 8q, and 15q. Each clone with JT was associated with trisomy 8. oaCGH analysis revealed an additional submicroscopic deletion in 3q13.31 as well as small subtelomeric duplications on several chromosomes. Locus-specific FISH with BAC-based probes from the 3q13.31-q13.32 region showed great heterogeneity. Telomere FISH revealed significantly reduced telomeric content in the aberrant cells with JT compared with cytogenetically normal cells at diagnosis and in normal cells at complete remission. A literature search revealed two previous de novo AML-M5 cases of JT involving the 3q13.3-qter chromosomal segment and concomitant trisomy 8. In addition, a case with an unbalanced der(Y)t(Y;3)(q12;q13.31) and additional trisomy 8 was previously reported in a patient with de novo AML-M5. All of these cases had a dismal outcome. In the present case, and in the der(Y)t(Y;3) case, a concurrent submicroscopic deletion at 3q13.31 was observed affecting the TUSC7 gene. Duplication of 3q13.31-qter might be a non-random chromosomal abnormality with concomitant submicroscopic deletion at 3q13.31 occurring in rare cases of acute monocytic leukemia, being associated with adverse prognosis. The impact of shortened telomeres in forming the JT is reviewed.
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MESH Headings
- Aged
- Chromosome Deletion
- Chromosome Duplication
- Chromosomes, Human, Pair 3/genetics
- Chromosomes, Human, Pair 8/genetics
- Cloning, Molecular
- Comparative Genomic Hybridization
- DNA Copy Number Variations
- Female
- Humans
- In Situ Hybridization, Fluorescence
- Karyotyping
- Leukemia, Monocytic, Acute/diagnosis
- Leukemia, Monocytic, Acute/genetics
- Prognosis
- Translocation, Genetic
- Trisomy/genetics
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Affiliation(s)
- Eigil Kjeldsen
- Cancercytogenetic Section, Hemodiagnostic Laboratory, Department of Hematology, Center for Cancer and Inflammation, Aarhus University Hospital, Tage Hansens Gade 2, Ent. 4A, DK-8000 Aarhus C, Denmark.
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11
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Abstract
RATIONALE Cutaneous presentation preceding acute myeloid leukemia (AML) is rare, and the prognosis is poor. PATIENT CONCERNS We report 4 cases of AML cutis, where skin infiltration precedes any blood or bone marrow evidence of leukemia. We also reviewed 13 cases reported in English and Chinese literature. The 4 cases all presented typical cutaneous lesions without any systemic evidence of leukemia. Histopathological examination found that dense monomorphous cell infiltration involved the dermis. Some cells surrounded blood vessels and skin appendages in a concentric manner or showed single-row arrangement in the collagen fiber bundles. Uninvolved papillary dermis was found to separate normal epidermis from dermal infiltration. Minor cells had a large kidney-shaped or oval nucleus with nucleoli and slightly eosinophilic cytoplasm. Immunohistochemical analysis was positive for CD4, CD56, while CD123 was negative in all cases. DIAGNOSES AML-M5. INTERVENTIONS 2 patients received chemotherapy ,but others rejected treatment. OUTCOMES Most patients died within 1 year after the onset of skin lesions. LESSONS These findings suggest that skin infiltration of AML may precede any systemic evidence, and typical cutaneous lesions in elderly individuals may be indicative for AML.
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12
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Yang LL, Gan SL, Liu YF, Zhang QT, Li T, Ma J, Sun H. [Clinical characteristics of CD56(+) patients with acute monocytic leukemia and their prognostic significance]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2013; 21:596-600. [PMID: 23815905 DOI: 10.7534/j.issn.1009-2137.2013.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This study was aimed to investigate the clinical features of CD56(+) patients with acute monocytic leukemia (AML-M5) and their prognostic significance. The data of 76 newly-diagnosed patients from our hospital were analyzed retrospectively. Patients were divided into two groups: CD56(+) group (21 patients) and CD56(-) group (55 patients). The clinical features, CR rate, relapse rate, the duration of CR, and survival time of patients between the two groups were compared. The results indicated that the CD56(+) antigen was observed in 21 patients (27.6%), their median age was 51.5 years and with a range 16 - 70 years. Of the 21 CD56(+) patients, the high WBC count was found in 57.1% CD56(+) patients (12/21), but it only in 15% CD56(-) patients (P < 0.05). The extramedullary infiltration was seen in 13 CD56(+) patients, and accounted for 62% (13/21), meanwhile this infiltration was found in 18 CD56(-) patients (18/55) and accounted for 33% (P < 0.05). All cases immunophenotypically highly expressed CD13, CD33, CD64, CD11b, cMPO, CD38, in which only the expression frequency of CD11b was positively related with CD56 (r = 0.59, P < 0.05). The CR rate in CD56(+) group accounted for 60.0%, and had no significant difference in comparison with that in CD56(-) group. In CD56(+) group the relapse rate was 75% (P = 0.042), the mean duration of CR was 5.5 months (95%CI, 3.1 - 8.6, P = 0.002), the median overall survival time was 10.1 months (95%CI, 2.3 - 16.3, P = 0.001). and all these had statistical significance as compared with that in CD56(-) group. It is concluded that CD56(+) AML-M5 patients always complicate with high WBC count and extramedullary infiltration, their CR rate and duration of CR are lower and shorter respectively, their relapse rate and prognosis are high and poor respectively.
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Affiliation(s)
- Lin-Lin Yang
- Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Henan Province, China
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13
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Kato A, Ono Y, Nagahata Y, Yamauchi N, Tabata S, Yonetani N, Matsushita A, Ishikawa T. The need for continuing chemotherapy for leukemic cell lysis pneumopathy in patients with acute myelomonocytic/monocytic leukemia. Intern Med 2013; 52:1217-21. [PMID: 23728559 DOI: 10.2169/internalmedicine.52.9117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Although fatal pulmonary complications frequently occur during the course of acute leukemia, a minor proportion of the complications are due to leukemia itself. Infections, drug reactions and concomitant medical conditions are the major causes of respiratory distress in leukemic patients. We treated four patients with acute myeloid leukemia complicated by leukemic cell lysis pneumopathy (LCLP). All of the patients had leukemia of monocytoid origin and their respiratory function deteriorated soon after chemotherapy initiation. Although two of the patients required mechanical ventilation, all four improved after continued chemotherapy. Our experience indicates that, in cases of LCLP, chemotherapy should be continued with maximal respiratory support.
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MESH Headings
- Adolescent
- Aged
- Cell Death/physiology
- Female
- Humans
- Leukemia, Monocytic, Acute/blood
- Leukemia, Monocytic, Acute/diagnosis
- Leukemia, Monocytic, Acute/drug therapy
- Leukemia, Myelomonocytic, Acute/blood
- Leukemia, Myelomonocytic, Acute/diagnosis
- Leukemia, Myelomonocytic, Acute/drug therapy
- Leukemic Infiltration/blood
- Leukemic Infiltration/diagnosis
- Leukemic Infiltration/drug therapy
- Male
- Middle Aged
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Affiliation(s)
- Aiko Kato
- Departments of Hematology and Clinical Immunology, Kobe City Medical Center General Hospital, Japan.
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14
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Wang YX, Zhang JH, Hu YP, Cao FF, Zhang N, Chen F, Liu X, Zhang MY. [Significance and application value of multiparameter flow cytometry for differentiation of immunophenotype in chronic myelomonocytic leukemia, myelodysplastic syndrome and acute monocytic leukemia]. Zhongguo Shi Yan Xue Ye Xue Za Zhi 2012; 20:857-862. [PMID: 22931642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This study was purposed to analyse the immunophenotypic characteristics of chronic myelomonocytic leukemia (CMML), myelodysplastic syndromes (MDS) and acute monocytic leukemia (AML-M5b) by using multiparameter flow cytometry, and to explore its significance in diagnosis and differential diagnosis. The immunophenotypic characteristics of bone marrow samples from 14 CMML patients, 48 MDS patients, 46 AML-M5b patients and 18 normal persons were analyzed and compared by multiparametric flow cytometry. The results showed that the ratio of monocytes in CMML patients was obviously higher than that in MDS, AML-M5b patients and normal persons (P < 0.05), but there was no statistically significant difference between bone marrow samples of MDS and AML-M5b patients as well as normal persons. The ratio of blast cells in MDS patients was obviously higher than that in normal persons (P < 0.05), but did not show significant difference as compared with CMML patients. The ratio of mature granulocytes in AML-M5b patients was obviously lower than that in CMML and MDS patients as well as normal person bone marrow (P < 0.05). Certain differences of CD45/SSC characteristics in MDS, AML-M5b and CMML patients were found in comparison with normal persons. The abnormal expression of CD2, CD56, and CD14 tailing phenomenon were observed in CMML patients in comparison with bone marrow samples of MDS, AML-M5b and normal persons (P < 0.05). Lack and decrease of CD15 expression in MDS and CMML patients was significant different from AML-M5b and normal persons marrow, abnormal expression rate of CD15 in CMML patients was higher than that in MDS patients (P < 0.05), the CD13/CD11b/CD16 abnormal expression of granulocytes was seen in both CMML and MDS patients, but there was no statistically significant difference between them. Other antigens showed abnormality of varying degrees, but did not have any statistical significance. It is concluded that MDS, CMML and AML-M5b displayed a certain degree of similarity, and also possess their own immunophenotype characteristics. Comprehensive analysis of immunophenotype by multiparameter flow cytometry may be important for differential diagnosis among CMML, MDS and AML-M5b. High percentage of monocytes, abnormal coexpression of CD2, CD56 and CD14 tailing phenomenon, lack or decrease of CD15 as well as abnormal expression of CD13/CD11b/CD16 in granulocytes may play important roles in diagnosis of CMML.
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Affiliation(s)
- Yun-Xiu Wang
- China Medical University, Shenyang, Liaoning Province, China
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15
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Monteagudo B, Pérez-Valcárcel J, Gómez-Torreiro E. [Widespread nodules]. Actas Dermosifiliogr 2010; 101:723-724. [PMID: 20965016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Affiliation(s)
- B Monteagudo
- Complejo Hospitalario Arquitecto Marcide-Novoa Santos, Ferrol, A Coruña, España.
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16
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Malbora B, Senel E, Avci Z, Ozbek N. Purpuric nodules and macules on the scalp of an 18-month-old boy. Skinmed 2010; 8:305-306. [PMID: 21137646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
An 18-month-old boy was consulted to a pediatric clinic with a 5-month history of purpuric macules and nodules on the scalp. He had a history of trauma (falling down from a chair) to the scalp about 6 months before the consultation. He had been brought to an emergency department after the trauma. Cranial computed tomography revealed a small crack on the temporal bone. Purpuric macules and nodules of the scalp had been noticed on the control 1 month later. Results of total blood tests had been within normal limits. Dermatologic examination disclosed multiple pink to violaceous infiltrated cutaneous nodules and purpuric macules with diameters of0.5 to 1.5 cm on his scalp (Figure 1). No petechiae or ecchymoses were seen. Cervical lymphadenopathy was detected during physical examination. There was no hepatosplenomegaly. A punch biopsy was obtained from one of the infiltrated nodules and was sent for histopathologic examination. Histopathologic examination revealed diffuse dermal and subcutaneous edema, erythrocyte extravasation and infiltration by monomorphic cells with large hyperchromatic nuclei, and high mitotic activity (Figure 2). Histopathologic staining was positive for leukocyte common antigen and CD68 in these cells. Results of complete blood cell count of the patient were as follows: hemoglobin: 8.44 g/dL; white blood cell count: 29.2 x 10(9)/L; and platelet count 55.6 x 10(9)/L. Bone marrow aspirate results showed 68.4% blast cells and a biopsy specimen confirmed the diagnosis of acute myeloid leukemia, with flow cytometry findings positive for acute monoblastic leukemia (AML) French-American-British (FAB)-M5 phenotype. We initiated induction chemotherapy for AML (AML-M5) according to the AML Berlin-Frankfurt-Munster 2004 protocol.' Complete resolution of the leukemia cutis lesions was attained with chemotherapy at the end of the first month of treatment.
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Affiliation(s)
- Baris Malbora
- Department of Pediatric Hematology, Baskent University Faculty of Medicine, Ankara, Turkey
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17
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Gogălniceanu D, Trandafir V, Trandafir D, Popescu E. [Generalized gingival enlargement--early clinic manifestation in acute leukemia. Case report]. Rev Med Chir Soc Med Nat Iasi 2010; 114:576-579. [PMID: 20701007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Leukemia is a hematological disorder arises from a hematopoietic stem cell characterized by a disordered differentiation and proliferation of neoplastic cells. Rapidly forming generalized gingival hyperplasia is usually the first sign of this disease (especially in acute forms). This case report describes a 54-year-old female who presented rapid gingival enlargement in only three weeks time, heralding the presence of acute monocytic leukemia (AML-FAB M5). The patient was immediately referred for hematologic management, but died five weeks later. Dentists and generalists should always be on guard to observe any oral manifestations that may lead to the early diagnostic of systemic diseases.
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Affiliation(s)
- D Gogălniceanu
- Universitatea Apollonia Iaşi, Facultatea de Medicină Stomatologică Universitatea de Medicină şi Farmacie Gr.T. Popa Iaşi, Facultatea de Medicinä Dentară Spitalul Clinic Judetean de Urgenţe Sf. Spiridon Iaşi
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18
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19
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Xu N, Liu XL, DU QF, Liu Z, Zhong M, Lin R, Song LL, Yi ZS, Meng FY, Zhou SY. [CD56 and CD11b antigen expressions in patients with acute monocytic leukemia and the clinical implications]. Nan Fang Yi Ke Da Xue Xue Bao 2009; 29:1605-1608. [PMID: 19726305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To investigate the expressions of cell surface differentiation antigen CD56 and CD11b antigen in acute monocytic leukemic (AML-M(5)) cells and their clinical significance. METHODS A total of 113 cases of de nove adult AML-M(5) were examined genetically and immunologically using G-banding technique, interphase fluorescence in situ hybridization (I-FISH) and flow cytometry immunophenotyping, and the results were analyzed in relation to their clinical data. RESULTS Of the 113 cases, the expression rates of CD56 and CD11b was 28.32% and 73.45%, respectively. The CD56(+) patients had high CD11b expression, and the expression levels of CD11b and CD56 were positively correlated (P<0.05). The incidence of karyotypic abnormalities was 48.57% (55 cases) in these patients, including 25 (22.12%) with 11q23 aberrations. Twenty-five cases were positive for MLL gene abnormalities as found by I-FISH analysis. Compared with the patients positive for both CD56 and CD11b, those negative for both CD56 and CD11b showed increased peripheral blood white blood cell (WBC) count and also increased blast and progenitor cells in the bone marrow (P<0.05); the former patients often had karyotypic abnormalities, commonly involving 11q23 aberrations (P<0.05), whereas the latter patients presented more likely with extramedullary infiltration and refractory leukemia (P<0.01) with lowered complete remission rate and shortened median survival time (P<0.01). CD56-positive patients were more likely to have karyotypic abnormalities and refractory leukemia than CD11b-postive patients (P<0.05), but the peripheral blood WBC counts, bone marrow blast and progenitor cells, extramedullary infiltration, complete remission rate or median survival time showed no significant differences between them (P>0.05). CONCLUSION AML-M(5) patients with CD56 positivity and high expression of CD11b often have aberrant karyotypes, commonly involving 11q23/MLL gene abnormality. These patients frequently develop extramedullary infiltration and refractory leukemia often with poor prognosis.
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Affiliation(s)
- Na Xu
- Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou 50515, China
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20
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Athanasiadis GI, Pfab F, Braun-Falco M, von Bubnoff N, Fend F, Ring J, Ollert M. Subcutaneous nodules revealing acute monoblastic leukaemia (FAB type M5A). J Eur Acad Dermatol Venereol 2007; 21:1296-7. [PMID: 17894748 DOI: 10.1111/j.1468-3083.2007.02198.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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21
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Gorello P, La Starza R, Brandimarte L, Trisolini SM, Pierini V, Crescenzi B, Limongi MZ, Nanni M, Belloni E, Tapinassi C, Gerbino E, Martelli MF, Foà R, Meloni G, Pelicci PG, Mecucci C. A PDGFRB-positive acute myeloid malignancy with a new t(5;12)(q33;p13.3) involving the ERC1 gene. Leukemia 2007; 22:216-8. [PMID: 17690697 DOI: 10.1038/sj.leu.2404894] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
MESH Headings
- Adaptor Proteins, Signal Transducing/genetics
- Adult
- Chromosomes, Human, Pair 12/genetics
- Chromosomes, Human, Pair 5/genetics
- Humans
- In Situ Hybridization, Fluorescence
- Leukemia, Monocytic, Acute/diagnosis
- Leukemia, Monocytic, Acute/genetics
- Leukemia, Monocytic, Acute/therapy
- Male
- Nerve Tissue Proteins/genetics
- Receptor, Platelet-Derived Growth Factor beta/genetics
- Translocation, Genetic
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22
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Yamamoto K, Okamura A, Kawano H, Katayama Y, Shimoyama M, Matsui T. A novel t(8;18)(q13;q21) in acute monocytic leukemia evolving from constitutional trisomy 8 mosaicism. ACTA ACUST UNITED AC 2007; 176:144-9. [PMID: 17656258 DOI: 10.1016/j.cancergencyto.2007.04.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2007] [Accepted: 04/26/2007] [Indexed: 10/23/2022]
Abstract
Constitutional trisomy 8 mosaicism (CT8M) has been considered to be the first mutation in multistep carcinogenesis. We describe the case of a 38-year-old woman with a normal phenotype who developed to acute monocytic leukemia with a novel t(8;18)(q13;q21). Chromosome analysis and spectral karyotyping showed 47,XX,+8,t(8;18)(q13;q21)[20]. Fluorescence in situ hybridization (FISH) demonstrated that the breakpoint at 18q21 was centromeric to the MALT1 and BCL2 genes. FISH also revealed that trisomy 8 was detected in buccal mucosa cells, indicating that trisomy 8 was a constitutional abnormality. These results suggest that t(8;18)(q13;q21) had a crucial role in the development of leukemia as the second mutation following CT8M.
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MESH Headings
- Adult
- Chromosomes, Human, Pair 18
- Chromosomes, Human, Pair 8
- Female
- Humans
- Leukemia, Monocytic, Acute/diagnosis
- Leukemia, Monocytic, Acute/genetics
- Leukemia, Monocytic, Acute/pathology
- Mosaicism
- Spectral Karyotyping
- Translocation, Genetic
- Trisomy/genetics
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Affiliation(s)
- Katsuya Yamamoto
- Hematology/Oncology, Department of Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan
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23
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Ramasamy K, Lim Z, Pagliuca A, Devereux S, Ho AYL, Mufti GJ. Acute myeloid leukaemia presenting with mediastinal myeloid sarcoma: report of three cases and review of literature. Leuk Lymphoma 2007; 48:290-4. [PMID: 17325888 DOI: 10.1080/10428190601059803] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Although myeloid sarcomas (MS) are frequently associated with acute myeloid leukaemia (AML), the occurrence of mediastinal MS is a much rarer event. The authors describe a distinct group of three AML patients with mediastinal MS and complex cytogenetics presenting at their centre over a 7-year period. Clinical features consistent with superior vena caval obstruction were noted at presentation in two of the three patients. Mediastinal mass was detected on routine chest radiography, and biopsies confirmed the diagnosis of MS. One patient relapsed after consolidation chemotherapy and died from progressive disease. Two patients underwent allogeneic haemopoietic stem cell transplant, but succumbed to transplant related complications. Review of mediastinal MS over the last 20 years shows that a significant proportion of patients have complex cytogenetic abnormalities and a poor long-term prognosis. Early and accurate diagnosis is essential and patients should be managed along the lines of high risk AML.
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MESH Headings
- Adult
- Chromosome Aberrations
- Female
- Humans
- Leukemia, Monocytic, Acute/diagnosis
- Leukemia, Monocytic, Acute/genetics
- Leukemia, Monocytic, Acute/therapy
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/therapy
- Male
- Mediastinal Neoplasms/diagnosis
- Mediastinal Neoplasms/genetics
- Mediastinal Neoplasms/therapy
- Neoplasms, Second Primary/diagnosis
- Sarcoma, Myeloid/diagnosis
- Sarcoma, Myeloid/genetics
- Sarcoma, Myeloid/therapy
- Superior Vena Cava Syndrome/pathology
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Affiliation(s)
- Karthik Ramasamy
- Department of Haematological Medicine, King's College London and King's College Hospital, UK
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24
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Jelier R, Jenster G, Dorssers LCJ, Wouters BJ, Hendriksen PJM, Mons B, Delwel R, Kors JA. Text-derived concept profiles support assessment of DNA microarray data for acute myeloid leukemia and for androgen receptor stimulation. BMC Bioinformatics 2007; 8:14. [PMID: 17233900 PMCID: PMC1784107 DOI: 10.1186/1471-2105-8-14] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2006] [Accepted: 01/18/2007] [Indexed: 12/02/2022] Open
Abstract
Background High-throughput experiments, such as with DNA microarrays, typically result in hundreds of genes potentially relevant to the process under study, rendering the interpretation of these experiments problematic. Here, we propose and evaluate an approach to find functional associations between large numbers of genes and other biomedical concepts from free-text literature. For each gene, a profile of related concepts is constructed that summarizes the context in which the gene is mentioned in literature. We assign a weight to each concept in the profile based on a likelihood ratio measure. Gene concept profiles can then be clustered to find related genes and other concepts. Results The experimental validation was done in two steps. We first applied our method on a controlled test set. After this proved to be successful the datasets from two DNA microarray experiments were analyzed in the same way and the results were evaluated by domain experts. The first dataset was a gene-expression profile that characterizes the cancer cells of a group of acute myeloid leukemia patients. For this group of patients the biological background of the cancer cells is largely unknown. Using our methodology we found an association of these cells to monocytes, which agreed with other experimental evidence. The second data set consisted of differentially expressed genes following androgen receptor stimulation in a prostate cancer cell line. Based on the analysis we put forward a hypothesis about the biological processes induced in these studied cells: secretory lysosomes are involved in the production of prostatic fluid and their development and/or secretion are androgen-regulated processes. Conclusion Our method can be used to analyze DNA microarray datasets based on information explicitly and implicitly available in the literature. We provide a publicly available tool, dubbed Anni, for this purpose.
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Affiliation(s)
- Rob Jelier
- Department of Medical Informatics, Erasmus MC – University Medical Center, Rotterdam, The Netherlands
| | - Guido Jenster
- Department of Urology, Erasmus MC – University Medical Center, Rotterdam, The Netherlands
| | - Lambert CJ Dorssers
- Department of Pathology, Erasmus MC – University Medical Center, Rotterdam, The Netherlands
| | - Bas J Wouters
- Department of Hematology, Erasmus MC – University Medical Center, Rotterdam, The Netherlands
| | - Peter JM Hendriksen
- Department of Urology, Erasmus MC – University Medical Center, Rotterdam, The Netherlands
| | - Barend Mons
- Department of Medical Informatics, Erasmus MC – University Medical Center, Rotterdam, The Netherlands
| | - Ruud Delwel
- Department of Hematology, Erasmus MC – University Medical Center, Rotterdam, The Netherlands
| | - Jan A Kors
- Department of Medical Informatics, Erasmus MC – University Medical Center, Rotterdam, The Netherlands
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25
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Aboujaoude R, Alvarez J, Alvarez M, Al Khan A. Acute myelogenous leukemia mimicking a hemolysis, elevated liver enzymes, and low platelets syndrome during pregnancy: case report and review of the literature. Am J Perinatol 2007; 24:1-4. [PMID: 17094046 DOI: 10.1055/s-2006-954955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Acute leukemia is a rare malignancy of pregnancy. When it develops, there are many complications to consider and management becomes exceedingly difficult. We report a case of acute myelogenous leukemia presenting as preeclampsia and fetal demise at 36 weeks of gestation. A 30-year-old multigravida presented with intrauterine fetal demise at 36 weeks' gestation, hypertension, and thrombocytopenia. The patient received platelet and packed red blood cell transfusion, with concurrent prophylactic magnesium sulfate and dexamethasone treatment. Following labor induction, the patient delivered a nonviable female fetus and suffered a stroke postpartum. Peripheral smear and flow cytometry revealed the patient had acute myeloid leukemia with prominent monocytic differentiation. The patient expired on postpartum day six. Acute leukemia during the pregnancy is associated with an unfavorable outcome.
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MESH Headings
- Adult
- Diagnosis, Differential
- Fatal Outcome
- Female
- Fetal Death
- Hemolysis
- Humans
- Leukemia, Monocytic, Acute/blood
- Leukemia, Monocytic, Acute/complications
- Leukemia, Monocytic, Acute/diagnosis
- Leukemia, Monocytic, Acute/pathology
- Liver/enzymology
- Platelet Transfusion
- Pregnancy
- Pregnancy Complications, Neoplastic/blood
- Pregnancy Complications, Neoplastic/diagnosis
- Pregnancy Complications, Neoplastic/pathology
- Pregnancy Trimester, Third
- Prenatal Diagnosis
- Thrombocytopenia/blood
- Thrombocytopenia/etiology
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Affiliation(s)
- Ramzi Aboujaoude
- New Jersey Medical School, University of Medicine and Dentistry, Newark, New Jersey, USA
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26
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Affiliation(s)
- Isao Miyoshi
- Department of Medicine, Kochi University School of Medicine
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27
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Abstract
Severe aplastic anemia (AA) is a life-threatening condition wherein bone marrow transplantation (BMT) is the therapy of choice in a young patient who has a matched sibling donor. Here, we report an 11-year-old boy with severe AA who was referred for BMT late in its course when he had developed acute myeloid leukemia following two courses of immunosuppressive therapy with antithymocyte globulin and cyclosporin. He was then treated with induction therapy using cytosine arabinoside and daunomycin for acute myeloid leukemia, but he succumbed due to infection and refractory leukemia. We discuss the relevance of early referral for BMT in severe AA.
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Affiliation(s)
- Sameer Bakhshi
- Department of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
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28
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Abstract
Cutaneous metastasis from thyroid carcinoma is infrequent. Leukemia as a second malignancy after treatment of thyroid cancer is also rare. We present a patient with a relapsed thyroid carcinoma treated with thyroid ablation with I 131 and loco-regional radiotherapy, who consulted by global worsening, weight lost, and multiple cutaneous nodes. Our patient is unusual in that she showed multisystem involvement at the time of hospital admission, and the specific skin lesions were the first sign of her acute monocytic leukemia.
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Affiliation(s)
- Fernando Arias
- Services of Oncology, Hospital de Navarra, Pamplona, Spain.
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29
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Haimi M, Motti H, Avivi I, Irit A, Moustafa N, Nivin M, Aboleil O, Olfat A, Gershoni-Baruch R, Ruth GB. Treatment-related acute myeloid leukemia characterized by t(11;20)(p15;q11) and del(9)(q22). ACTA ACUST UNITED AC 2006; 167:186-8. [PMID: 16737924 DOI: 10.1016/j.cancergencyto.2006.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2006] [Accepted: 01/24/2006] [Indexed: 10/24/2022]
MESH Headings
- Antineoplastic Agents/adverse effects
- Antineoplastic Agents/therapeutic use
- Chromosome Deletion
- Chromosomes, Human, Pair 11/ultrastructure
- Chromosomes, Human, Pair 20/ultrastructure
- Chromosomes, Human, Pair 9/ultrastructure
- Female
- Humans
- Leukemia, Monocytic, Acute/chemically induced
- Leukemia, Monocytic, Acute/diagnosis
- Leukemia, Monocytic, Acute/genetics
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Middle Aged
- Neoplasms, Second Primary/chemically induced
- Neoplasms, Second Primary/diagnosis
- Neoplasms, Second Primary/genetics
- Remission Induction
- Translocation, Genetic
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30
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Ferreira M, Caetano M, Amorim I, Selores M. Leukemia cutis resembling a flare-up of psoriasis. Dermatol Online J 2006; 12:13. [PMID: 16638427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023] Open
Abstract
Leukemia cutis represents a skin infiltration by leukemic cells. Clinically it can mimic a wide variety of dermatoses. We describe the case of a 64-year-old man with psoriasis who presented with a 4-day history of erythematous, slightly scaly, asymptomatic plaques distributed on the trunk and upper-extremities, and associated asthenia, myalgias, and anorexia. A skin biopsy revealed a leukemic infiltrate. Studies of peripheral blood and bone marrow provided a diagnosis of acute monocytic leukemia. This case report shows the importance of the clinical suspicion for the diagnosis of leukemia.
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Affiliation(s)
- Márcia Ferreira
- Service of Dermatology, Hospital Geral de Santo António, Porto, Portugal.
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31
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Yang DT, Greenwood JH, Hartung L, Hill S, Perkins SL, Bahler DW. Flow cytometric analysis of different CD14 epitopes can help identify immature monocytic populations. Am J Clin Pathol 2005; 124:930-6. [PMID: 16416743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
Accurate diagnosis of monocytic neoplasms often is dependent on quantitating monoblasts, promonocytes, and monocytes. However, distinguishing these populations by morphologic assessment alone can be difficult and subject to significant intraobserver variability. We evaluated a 4-color flow cytometry technique using different anti-CD14 antibodies that recognize the MO2 and MY4 epitopes to identify monoblasts, promonocytes, and monocytes. Normal control specimens and 18 cases of monocytic neoplasia were evaluated and results correlated with morphologic findings. We found the MY4 epitope first appearing at the early promonocyte stage and the MO2 epitope appearing only on mature monocytes after the promonocyte stage. Expression of the MY4 and MO2 epitopes by neoplastic monocyte populations was found to usually parallel the normal monocyte differentiation patterns, although exceptions were noted. Our study suggests that 4-color flow cytometry may be an especially useful adjunct for morphologically difficult cases by providing an immunophenotypic measure of neoplastic monoblasts and promonocytes.
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Affiliation(s)
- David T Yang
- Department of Pathology, University of Utah, Salt Lake City, USA
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32
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Affiliation(s)
- Dominic J Valentino
- Department of Pulmonary, Critical Care, and Sleep Medicine, Georgetown University Hospital, Washington, DC, USA.
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33
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Abstract
A three-year-old cat with lymphadenopathy, non-regenerative anaemia and marked leucocytosis (171.3 x 10(9) white blood cells/l) was diagnosed with monocytic leukaemia and treated with a combination of anticancer drugs. A number of mature and immature monocyte-like cells were detected in the peripheral blood and bone marrow; they proved to be monocytic cells by cytochemical examination and an analysis of their cell surface phenotype, indicating that the cat suffered from acute myeloid leukaemia, subclassified as monocytic leukaemia (M5). Treatment with cytarabine, doxorubicin, vincristine and prednisolone greatly reduced the number of blast cells in the cat's peripheral blood and bone marrow. The cat was in partial remission for 67 days and survived for 95 days after it was first examined.
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Affiliation(s)
- N Nagashima
- Department of Pathobiology, Nihon University School of Veterinary Medicine, Fujisawa Kanagawa 252-8510, Japan
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Abstract
AIMS The diagnosis of primitive hematologic malignancies depends on a panel of monoclonal antibodies which is growing over time. The distinction between immature (lymphoblastic lymphoma/acute lymphoblastic leukaemia) and mature lymphoma is sometimes difficult. In this study, we evaluated anti-TdT antibody in the diagnosis and classification of these proliferations. MATERIALS AND METHODS 13 lesions were examined by immunohistochemistry: 4 B and T lymphoblastic lymphomas, 2 Burkitt's lymphomas, 5 B and T acute lymphoblastic leukemias and 2 acute monoblastic leukemias. RESULTS TdT expression is specific of immature lymphoid proliferations (T or B lymphoblasts). TdT is not expressed by mature B or T cell lymphomas such as Burkitt's lymphomas. Significant numbers of cases of acute myeloblastic leukemias are TdT positive but could be easily distinguished from lymphoblastic proliferations. CONCLUSION Anti-TdT antibody represents a useful marker for differentiating lymphoma/acute lymphoblastic leukemia from other lymphomas. This marker, available in routine diagnosis should be systematically included in the panel of antibodies used for immunophenotyping hematologic malignancies.
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Affiliation(s)
- Séverine Valmary
- Laboratoire d'Anatomie et Cytologie pathologiques, Hôpital Purpan, 1 place du Docteur Baylac, 31059 Toulouse .
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35
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Kurosawa H, Tsuboi T, Shimaoka H, Okuya M, Nakajima D, Matsunaga T, Hagisawa S, Sato Y, Sugita K, Eguchi M. [Long-term remission in an acute monoblastic leukemia patient with down syndrome after cord blood transplantation]. Rinsho Ketsueki 2005; 46:274-7. [PMID: 16444960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
A 4-year-old boy with Down syndrome (DS) was diagnosed as having acute monoblastic leukemia (AML-M5a). Leukemic cells were CD33+, CD56+ and CD4+, with t(9;11) on cytogenetic analysis and MLL gene rearrangement. After 2 courses of induction therapy using an AML 99-Down protocol failed to obtain complete remission, the patient received cord blood transplantation from an HLA-matched donor (CBT) following a conditioning regimen comprising total body irradiation and cyclophosphamide. Only cyclosporin A was used for graft-versus-host disease prophylaxis. Stem cell transplantation may not be indicated for AML patient with DS in first remission, who display a high rate of life-threatening and fatal toxicity on therapy. This patient remained well controlled in complete remission for 4 years, representing a rare case of DS with chemotherapy-resistant AML successfully treated with a CBT.
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36
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Yanada M, Terakura S, Yokozawa T, Yamamoto K, Kiyoi H, Emi N, Kitamura K, Kohno A, Tanaka M, Tobita T, Takeo T, Sao H, Kataoka T, Kobayashi M, Takeshita A, Morishita Y, Naoe T, Sugiura I. Multiplex real-time RT-PCR for prospective evaluation of WT1 and fusion gene transcripts in newly diagnosed de novo acute myeloid leukemia. Leuk Lymphoma 2005; 45:1803-8. [PMID: 15223639 DOI: 10.1080/10428190410001693551] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Prognostic assessment is crucial for the management of AML. Although the use of karyotype analysis for risk-stratification is widely accepted, prognosis of AML remains ambiguous, particularly for patients categorized into the intermediate cytogenetic risk group and additional markers are required for an accurate prediction of outcome. For this study, we used multiplex real-time RT-PCR, which can simultaneously quantify WT1 and 10 distinct fusion gene transcripts, to prospectively evaluate the pre-treatment bone marrow findings of 53 de novo AML patients. Five patients with normal karyotype or insufficient metaphases detected by conventional karyotype analysis proved to have AML1-MTG8, CBFbeta-MYH11 or PML-RARalpha fusion transcripts. WT1 overexpression was observed in 92% of the patients, and the levels were significantly higher in the cytogenetic favorable risk group, especially patients with PML-RARalpha. WT1 levels also correlated with the percentage of blasts in bone marrow, especially in cases of core-binding factor leukemia. There was no association between initial WT1 levels and outcome in terms of event-free survival or overall survival. These results suggest that multiplex real-time RT-PCR is rapid and useful for the precise cytogenetic stratification of AML, and that WT1 levels at presentation correlate with several biologic features of leukemia, but have no prognostic significance.
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Affiliation(s)
- Masamitsu Yanada
- Department of Hematology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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37
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Affiliation(s)
- Rashid Fuad Kysia
- Division of Emergency Medicine, Harvard Medical School, Boston, Massachusetts 02115, USA
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38
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Kang SP, Liu DB, Qureshi A, Seiter K. Presentation of extramedullary acute myelogenous leukemia as bilateral testicular masses: response to non-myeloablative allogeneic transplantation. Leuk Lymphoma 2004; 45:1481-3. [PMID: 15359653 DOI: 10.1080/10428190310001653718] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We present an unusual case of extramedullary acute myelogenous leukemia (AML) presenting as bilateral testicular masses. The patient subsequently developed diffuse skin lesions and bone marrow involvement. Although he had only a partial response to intensive chemotherapy, the patient obtained a complete remission after non-myeloablative allogeneic transplantation.
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Affiliation(s)
- S Peter Kang
- Department of Medicine, New York Medical College, Valhalla, New York 10595, USA
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39
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Tallman MS, Kim HT, Paietta E, Bennett JM, Dewald G, Cassileth PA, Wiernik PH, Rowe JM. Acute Monocytic Leukemia (French-American-British classification M5) Does Not Have a Worse Prognosis Than Other Subtypes of Acute Myeloid Leukemia: A Report From the Eastern Cooperative Oncology Group. J Clin Oncol 2004; 22:1276-86. [PMID: 14970186 DOI: 10.1200/jco.2004.08.060] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Acute monocytic leukemia is a distinct subtype of acute myeloid leukemia (AML) with characteristic biologic and clinical features. This study was designed to compare the outcome of patients with M5 to that of other subtypes of AML, and to identify differences in M5a and M5b. Patients and Methods We reviewed all patients with AML M5 entered in three clinical trials for newly diagnosed AML conducted by the Eastern Cooperative Oncology Group between 1989 and 1998. Eighty-one patients, 21 with M5a and 60 with M5b, were identified. Results The complete remission rate was 62% for all patients with M5; 52% for patients with M5a and 65% for patients with M5b (P = .3), and 60% for the 1,122 patients with non-M5 AML entered on the same clinical trials (P = .8 for M5 v non-M5). The 3-year disease-free survival was 26% for all M5 patients; 18% for M5a and 28% for M5b (P = .31), and 33% for non-M5 patients (P = .13 for M5 v non-M5). The 3-year overall survival was 31% for all M5 patients; 33% for M5a and 30% for M5b (P = .65), and 30% for non-M5 (P = .74 for M5 v non-M5). The karyotypes of patients with AML M5 were heterogeneous. CD11b was the only leukemic cell antigen expressed differently in M5a (53%) compared to M5b (77%) to a significant degree (P = .02). Conclusion AML M5 represents an immunologically heterogeneous population similar to non-M5 AML with a prognosis that is not dependent on morphology. The disease-free survival and overall survival of patients with M5a, M5b, and non-M5 appear not to differ with currently available therapy.
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Affiliation(s)
- Martin S Tallman
- Northwestern University Feinberg School of Medicine, Robert H Lurie Comprehensive Cancer Center, Chicago, IL 60611, USA.
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40
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Gorczyca W. Flow Cytometry Immunophenotypic Characteristics of Monocytic Population in Acute Monocytic Leukemia (AML-M5), Acute Myelomonocytic Leukemia (AML-M4), and Chronic Myelomonocytic Leukemia (CMML). Methods Cell Biol 2004; 75:665-77. [PMID: 15603447 DOI: 10.1016/s0091-679x(04)75028-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
MESH Headings
- Antigens, CD/analysis
- Cell Count
- Diagnosis, Differential
- Flow Cytometry/methods
- HLA-DR Antigens/analysis
- Humans
- Immunophenotyping/methods
- Leukemia, Megakaryoblastic, Acute/diagnosis
- Leukemia, Megakaryoblastic, Acute/immunology
- Leukemia, Monocytic, Acute/diagnosis
- Leukemia, Monocytic, Acute/immunology
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/immunology
- Leukemia, Myelomonocytic, Acute/diagnosis
- Leukemia, Myelomonocytic, Acute/immunology
- Leukemia, Myelomonocytic, Chronic/diagnosis
- Leukemia, Myelomonocytic, Chronic/immunology
- Leukemia, Promyelocytic, Acute/diagnosis
- Leukemia, Promyelocytic, Acute/immunology
- Leukocytes/immunology
- Leukocytes/pathology
- Monocytes/immunology
- Monocytes/pathology
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Affiliation(s)
- Wojciech Gorczyca
- Hematopathology/Oncology Services, Genzyme Genetics/IMPATH, New York, New York 10019, USA
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41
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Abstract
Granulocytic sarcoma or chloroma is a tumor composed of myeloblast or monoblast. These tumors may be found in any location of the body and occur in 5% of acute myeloid leukemia (AML) cases and are more common in pediatric patients. In this report we describe the case of a 27-year-old male who developed lower motor neuron seventh nerve palsy followed by swelling of the parotid gland. Fine-needle aspiration cytology (FNAC) of the soft tissue swelling revealed scattered blasts, and peripheral smear and bone marrow aspirate examination suggested AML. This is a rare presentation of a granulocytic sarcoma leading to a diagnosis of AML.
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Affiliation(s)
- Bhrigu Raj Sood
- Department of Medicine, Indira Gandhi Medical College, Shimla, HP India.
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42
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Abstract
Abstract
Acute leukemia frequently has been described as a late complication of chemotherapy with alkylating agents in patients treated for multiple myeloma. However, the simultaneous occurrence of multiple myeloma and acute leukemia in the same patient, without previous exposure to chemotherapy, is a rare association. We describe a case of concomitant involvement by multiple myeloma and acute monocytic leukemia. To our knowledge, only 9 such cases have been reported in the literature to date. We discuss the criteria used in diagnosing the 2 separate diseases and the possible mechanisms responsible for this occurrence.
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Affiliation(s)
- Dragos C Luca
- Department of Pathology, Advocate Lutheran General Hospital, Park Ridge, Ill 60068, USA
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43
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Jones LK, Neat MJ, van Delft FW, Mitchell MP, Adamaki M, Stoneham SJ, Patel N, Saha V. Cryptic rearrangement involving MLL and AF10 occurring in utero. Leukemia 2003; 17:1667-9. [PMID: 12886258 DOI: 10.1038/sj.leu.2403039] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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44
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da Fonseca LM, Brunetti IL, Campa A, Catalani LH, Calado RT, Falcão RP. Assessment of monocytic component in acute myelomonocytic and monocytic/monoblastic leukemias by a chemiluminescent assay. Hematol J 2003; 4:26-30. [PMID: 12692517 DOI: 10.1038/sj.thj.6200209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Classically, the monocytic component of acute myelomonocytic (FAB-M4) and acute monocytic/monoblastic (FAB-M5) leukemias is demonstrated by nonspecific esterase positivity in cytochemical stainings. We have previously demonstrated that non-specific esterases from normal monocytes can be determined by a chemiluminescent method. In the present study, we investigated whether this assay can also determine the monocytic component of FAB-M4 and FAB-M5 and distinguish these acute myeloid leukemia (AML) categories. MATERIALS AND METHODS Bone marrow samples were obtained from 66 patients with AML (M0, two cases; M1, 12 cases; M2, 13 cases; M3, 10 cases; M4, 11 cases; M5, 12 cases; M6, two cases; M7, four cases). Cells were incubated with a standard reaction mixture and chemiluminescence was measured for 10 min. Two parameters were assessed, the peak (PLE) and the integrated light emission (ILE). RESULTS Both PLE and ILE were higher in FAB-M4 and FAB-M5 subtypes compared to other AML subtypes (P<0.001). In addition, the classification of AML cases into FAB-M4, FAB-M5 and nonmonocytic subtypes based on ILE analysis was concordant with alpha-naphthyl acetate esterase (ANAE) in 97% of cases (kappa coefficient 0.94, P<0.001). CONCLUSIONS These findings indicate that this chemiluminescent assay was able to determine the monocytic component of FAB-M4 and FAB-M5 cells, and the classification of AML subtypes based on chemiluminescent analysis strongly agreed with the cytochemical ANAE-staining. In conclusion, this chemiluminescent assay is a simple, fast and objective method, which may be useful as an alternative tool in the differential diagnosis of AML subtypes.
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MESH Headings
- Acute Disease
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Benzoates/metabolism
- Bone Marrow/pathology
- Carboxylesterase
- Carboxylic Ester Hydrolases/analysis
- Child
- Child, Preschool
- Cryopreservation
- Diagnosis, Differential
- Female
- Horseradish Peroxidase/metabolism
- Humans
- Leukemia, Monocytic, Acute/diagnosis
- Leukemia, Monocytic, Acute/enzymology
- Leukemia, Monocytic, Acute/pathology
- Leukemia, Myeloid/pathology
- Leukemia, Myelomonocytic, Acute/diagnosis
- Leukemia, Myelomonocytic, Acute/enzymology
- Leukemia, Myelomonocytic, Acute/pathology
- Luminescent Measurements
- Male
- Middle Aged
- Monocytes/enzymology
- Monocytes/pathology
- Neoplasm Proteins/analysis
- Neoplastic Stem Cells/enzymology
- Neoplastic Stem Cells/pathology
- Sodium Fluoride/pharmacology
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Affiliation(s)
- Luiz M da Fonseca
- Department of Clinical Analysis, State University of São Paulo School of Pharmaceutical Sciences, Araraquara, Brazil
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45
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Rodríguez Guerrero JM, Martín Hidalgo JR, Alonso Alejandro E, Pérez Ríos N, Roussel J, Rodríguez Pardo F, Rosal Obrador J, Bascuñana Quirel A. [Granulocytic sarcoma (chloroma) of small bowel: an unfrequent cause of intestinal obstruction]. Gastroenterol Hepatol 2003; 26:347-50. [PMID: 12809571 DOI: 10.1016/s0210-5705(03)70371-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Granulocytic sarcoma or chloroma is a malignant extra medullar tumor, based on inmature myeloid cells. It usually emerges as a secondary manifestation of acute myeloid leukemia. Chloromas are scarcely diagnosed in patiens without hematological malignances, either peripheral or medullar, and are thus frequently misdiagnosed for other tumors. In these patients, further development of acute leukemia seems to stand as a rule. Small bowel location of these tumors has hardly been reported. A case of granulocytic sarcoma in a non-leukemic at time of diagnosis patient is reported therein. Medical literature is briefly reviewed.
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MESH Headings
- Adult
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Humans
- Hydronephrosis/etiology
- Ileal Neoplasms/complications
- Ileal Neoplasms/diagnosis
- Ileal Neoplasms/surgery
- Intestinal Obstruction/etiology
- Jejunal Neoplasms/complications
- Jejunal Neoplasms/diagnosis
- Jejunal Neoplasms/surgery
- Leukemia, Monocytic, Acute/complications
- Leukemia, Monocytic, Acute/diagnosis
- Leukemia, Monocytic, Acute/drug therapy
- Male
- Neoplasm Recurrence, Local
- Remission Induction
- Sarcoma, Myeloid/complications
- Sarcoma, Myeloid/diagnosis
- Sarcoma, Myeloid/surgery
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Affiliation(s)
- J M Rodríguez Guerrero
- Servicios de Aparato Digestivo. Hospital Virgen del Camino. Sanlúcar de Barrameda. Cádiz. España
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46
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Azoulay E, Fieux F, Moreau D, Thiery G, Rousselot P, Parrot A, Le Gall JR, Dombret H, Schlemmer B. Acute monocytic leukemia presenting as acute respiratory failure. Am J Respir Crit Care Med 2003; 167:1329-33. [PMID: 12574074 DOI: 10.1164/rccm.200206-554oc] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Acute respiratory failure revealing acute monocytic leukemia is rare. We report 20 patients admitted to the intensive care unit (ICU) with three remarkable features: (1) rapidly progressive respiratory distress revealing acute leukemia, (2) monocytic leukemia, and (3) respiratory status deterioration after chemotherapy initiation. The median age was 50 years (17-72 years), and respiratory symptoms started 2 days (0-15 days) before ICU admission. The median leukocyte count was 98,250/mm3 (800-529,000), with circulating monocytic cells in all of the patients but one. Bone marrow examination was diagnostic of monocytic leukemia in all patients. At presentation, respiratory rate was 33 (18-50) per minute, and PaO2 on room air was 44.5 mm Hg (30-60). Chest radiographs revealed unilateral alveolar infiltrates (n = 1), bilateral alveolar infiltrates with (n = 3) or without (n = 11) pleural effusion, or diffuse interstitial infiltrates (n = 5). Alveolar hemorrhage was the main bronchoalveolar lavage finding, with monocytic cells retrieved from four patients. Respiratory function deteriorated after cancer chemotherapy initiation in all patients. Of the 15 patients who required mechanical ventilation, 10 died. Leukemic pulmonary infiltration as the first manifestation of acute monocytic leukemia should be recognized, and intensive management should be provided in anticipation of the respiratory function deterioration seen consistently after chemotherapy initiation.
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Affiliation(s)
- Elie Azoulay
- Medical Intensive Care Unit, Hematology Department, Saint-Louis Teaching Hospital, Paris 7 University, France.
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47
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Walter RB, Bächli EB, Schaer DJ, Rüegg R, Schoedon G. Expression of the hemoglobin scavenger receptor (CD163/HbSR) as immunophenotypic marker of monocytic lineage in acute myeloid leukemia. Blood 2003; 101:3755-6. [PMID: 12707228 DOI: 10.1182/blood-2002-11-3414] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
MESH Headings
- Acute Disease
- Antigens, CD
- Antigens, Differentiation, Myelomonocytic/analysis
- Antigens, Neoplasm/analysis
- Biomarkers, Tumor/analysis
- Cell Lineage
- Humans
- Immunophenotyping/methods
- Leukemia, Monocytic, Acute/diagnosis
- Leukemia, Monocytic, Acute/pathology
- Leukemia, Myeloid/classification
- Leukemia, Myeloid/pathology
- Leukemia, Myelomonocytic, Acute/diagnosis
- Leukemia, Myelomonocytic, Acute/pathology
- Monocytes/chemistry
- Neoplastic Stem Cells/chemistry
- Receptors, Cell Surface/analysis
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48
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Tomonari A, Shirafuji N, Tojo A, Iseki T, Ooi J, Komiya I, Tani K, Asano S. Acute myelogenous leukemia M5b developed during clinical remission of Castleman disease. Int J Hematol 2003; 77:274-6. [PMID: 12731671 DOI: 10.1007/bf02983785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Castleman disease (CD) is a rare heterogeneous lymphoproliferative disease characterized by clinical symptoms due to an excess of interleukin-6 (IL-6) or IL-6-like activity. We describe the first case of CD associated with acute myelogenous leukemia (AML). A 55-year-old man presented with skin rash on his face and multiple cervical lymphadenopathy. The results of examination of his lymph node biopsy specimen led to a diagnosis of CD. The symptoms resolved after the administration of prednisolone. Three years after the onset of CD, the patient's white blood cell count had increased to 63.4 x 10(9)/L. His bone marrow aspirate showed that approximately 80% of cells were leukemic, including well-differentiated monocytic cells A diagnosis of AML M5b was made. The patient died of invasive pulmonary aspergillosis after chemotherapy.
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Affiliation(s)
- Akira Tomonari
- Department of Hematology/Oncology, The Institute of Medical Science, The University of Tokyo, Japan.
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49
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Vizmanos JL, Larráyoz MJ, Lahortiga I, Floristán F, Alvarez C, Odero MD, Novo FJ, Calasanz MJ. t(10;16)(q22;p13) and MORF-CREBBP fusion is a recurrent event in acute myeloid leukemia. Genes Chromosomes Cancer 2003; 36:402-5. [PMID: 12619164 DOI: 10.1002/gcc.10174] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Recently, it was shown that t(10;16)(q22;p13) fuses the MORF and CREBBP genes in a case of childhood acute myeloid leukemia (AML) M5a, with a complex karyotype containing other rearrangements. Here, we report a new case with the MORF-CREBBP fusion in an 84-year-old patient diagnosed with AML M5b, in which the t(10;16)(q22;p13) was the only cytogenetic aberration. This supports that this is a recurrent pathogenic translocation in AML.
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MESH Headings
- Acetyltransferases/genetics
- Aged
- Aged, 80 and over
- CREB-Binding Protein
- Chromosomes, Human, Pair 10/genetics
- Chromosomes, Human, Pair 16/genetics
- Cytogenetic Analysis/methods
- Fatal Outcome
- Histone Acetyltransferases
- Humans
- Leukemia, Monocytic, Acute/diagnosis
- Leukemia, Monocytic, Acute/genetics
- Male
- Neoplasm Recurrence, Local/genetics
- Nuclear Proteins/genetics
- Oncogene Proteins, Fusion/genetics
- Saccharomyces cerevisiae Proteins/genetics
- Trans-Activators/genetics
- Translocation, Genetic/genetics
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Affiliation(s)
- José L Vizmanos
- Department of Genetics, School of Science, University of Navarra, C/Irunlarrea s/n, 31080 Pamplona, Spain.
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50
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Abstract
Congenital leukemia is a rare disease developing within the first 4 to 6 weeks of life. We report a female infant born with facial mass and multiple subcutaneous nodules. The facial mass was discovered by ultrasound during a routine prenatal examination at the 36th week of gestation. Biopsies were consistent with the diagnosis of acute monoblastic leukemia (AML, FAB M5b). Cytogenetic studies showed 46 XX, t(11;19)(q23;p13.1), which is only found in acute monoblastic leukemia and involves the gene. The infant died at 12 days of age and autopsy revealed a large leukemic tumor burden in several body organs. The discovery of the facial mass prenatally and massive extramedullary leukemic burden support the notion of the in utero development of congenital leukemia.
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Affiliation(s)
- Mohamed Bayoumy
- Section of Hematology/Oncology, Columbus Children's Hospital, Ohio 43205, USA
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