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目的探讨微分化急性髓系白血病(ANLL-M0)细胞形态学、细胞化学、细胞免疫学、细胞遗传学特性。方法2006年9月至2007年5月在华中科技大学同济医学院附属协和医院儿科住院的初诊和复发的ANLL-M0患儿5例,骨髓涂片用Wright-Giemsa染色、POX染色、PAS染色、NES染色及NaF抑制试验、SB染色、MPO染色,骨髓液用流式细胞单克隆抗体直接免疫标记技术检测白血病细胞表面相关抗原分化群,短期培养法直接法G显带分析白血病细胞染色体组型。结果5例细胞学均报告为原始+幼稚淋巴细胞增多,POX、MPO染色阴性,PAS染色部分阳性;髓系标志CD13、CD33、CD117至少1项阳性和(或)MPO染色阳性,而淋巴系统及巨核细胞系统抗原阴性;AML-M0核型异常的发生率高。结论骨髓细胞形态学、细胞化学、免疫表型、细胞遗传学是诊断AML-M0的主要依据,原始细胞的免疫表型对诊断AML-M0有着重要价值。
Objective To investigate the morphology, cytochemistry, immunology and cytogenetics of differentiated acute myeloid leukemia (ANLL-M0) cells. Methods From September 2006 to May 2007, 5 newly diagnosed and relapsed children with ANLL-M0 were admitted to the Peking Union Medical College Hospital, Huazhong University of Science and Technology. Wright-Giemsa staining, POX staining, PAS staining, NES staining and NaF inhibition test, SB staining and MPO staining. The bone marrow fluid was detected by flow cytometry direct immunofluorescence staining for leukemic cell surface antigen-related differentiation groups. The short-term culture method was used to analyze the G-banding of leukemic cells by direct culture. Results All 5 cases of cytology were reported as primitive + naive lymphocytes, negative for POX and MPO staining, and partially positive for PAS staining. At least 1 positive and / or MPO staining of myeloid markers CD13, CD33 and CD117 were positive, while lymphoid and Megakaryocytic system antigen negative; AML-M0 karyotype abnormalities high incidence. Conclusion The morphology, cytochemistry, immunophenotyping and cytogenetics of bone marrow cells are the main basis for diagnosis of AML-M0. The immunophenotype of blast cells is of great value in the diagnosis of AML-M0.