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目的探讨急性巨核细胞白血病(FAB-M7)以外的急性髓细胞白血病(AML)患者化疗期间一过性不典型巨核细胞增生(AMH)现象。方法对45例AML患者化疗后不同间隔经一步法骨髓抽吸涂片-活检切片双标本取材,同时观察涂片与切片内的AMH。结果①各例于化疗前均未检出AMH;②34例于诱导化疗中检出AMH,8例于完全缓解(CR)期看到AMH;③诊断至发生AMH的时间在2～15周间。25例(55.6%)患者于治疗最初8周内发生AMH;④32例(71%)于骨髓涂片内检出AMH,而42例(93%)于切片内发现AMH,切片优于涂片;⑤6例定期随访,骨髓涂片和切片内的AMH均于32周内消失。结论通晓此种化疗后最初数月内的一过性AMH现象,对于避免误诊及改变治疗有意义。
Objective To investigate the phenomenon of transient atypical megakaryocyte hyperplasia (AMH) during chemotherapy in patients with acute myeloid leukemia (AML) other than acute megakaryoblastic leukemia (FAB-M7). Methods Fifty-five patients with AML were treated with one-step bone marrow aspiration-biopsy biopsy specimens at different intervals after chemotherapy, and the AMH in smear and section was observed. Results ① No AMH was detected in all cases before chemotherapy; 34 cases were detected with AMH in induction chemotherapy, 8 cases were found with AMH in complete remission (CR); ③The time from diagnosis to occurrence of AMH was between 2 and 15 weeks. AMH was found in 25 cases (55.6%) within the first 8 weeks of treatment; (3) AMH was detected in 32 cases (71%) in bone marrow smears, and AMH was found in 42 cases (93% ⑤ 6 cases of regular follow-up, bone marrow smear and intramuscular AMH within 32 weeks disappear. Conclusions Knowing the transient AMH in the first few months after this chemotherapy is meaningful to avoid misdiagnosis and change of treatment.