急性早幼粒细胞白血病细胞形态学分型与临床关系的研究

Typing of the acute hypergranular promyelocytic leukenia

目的 为解决目前国内急性早幼粒细胞白血病 (M3)因粗细颗粒混杂而造成的分型困难。方法 以粗颗粒型早幼粒细胞的百分率进行分型 ,规定 :粗颗粒型早幼粒细胞 >70 %为M3a(粗颗粒型 ) ;30 % <粗颗粒型早幼粒细胞≤70 %为M3b(混合颗粒型 ) ;粗颗粒型早幼粒细胞≤ 30 %为M3c(细颗粒型 )。结果 3种亚型在性别、年龄分布上 ,以及在临床症状、血象、骨髓象上均有不同的表现与特征。结论 对于临床治疗和判断预后具有指导意义 。

Objective To found solution of difficulties in typing of acute hepergranular promyelocytic leukemia (M 3) due to mixed up of fine and coarse granules. Methods The proposed typing, based on the percentage of M 3 cells with coarse granules in the cytoplasm, divided M 3 into three subtypes: M 3a (coarse granule subtype)in which >70% of the leukemia cells contained coarse granules, M 3b (mixed granule subtype) in which 30% to 70% of the leukemia cells contained coarse granules, and M 3c (fine granule subtype) in which ≤30% of the leukemia cells contained coarse granules. Results The three subtypes were different in age and sex distribution, clinical signs and symptoms, and peripheral blood and bone marrow smear characteristics. Conclusion The proposed subtyping could be reference value for treatment and prognosis. It also facilitated the exchanges of academic information based on a set of universal subtyping criteria.