[Immunologic prognostication of development of recurrences in patients with acute myeloid leukemia]

Morphological study of the bone marrow and blood, cytochemical examination with evaluation of lysosomal enzymes activity, concentrations of glycogen and acid sulfated mucopolysaccharides, and immunophenotyping were conducted to develop immunomorphological criteria early detecting leukemic clone in patients with acute nonlymphoblastic leukemia (ANLL) in remission based on dynamic immunological monitoring of peripheral blood lymphocytes for recurrence prognostication. Immunological monitoring of lymphoid population of ANLL patients' peripheral blood allowed to predict recurrence in remission, several months before its morphological identification in all the patients. This was accomplished by a significant increase in the levels of (M + 3 sigma) lymphocytes with antigens of early differentiation stages atypical for mature lymphocytes. Practical value of the method is not only in providing immunophenotypical appearance of the blast cells in various ANLL variants, but also in the control by the detected antigens over the residual leukemic population during treatment, and in prediction of the disease recurrence by reversion in the spectrum of differential antigens on the lymphocytes in remission. The latter indicates the increase of the leukemic clone and may be recognized several months before evident clinicomorphological signs of the aggravation.