混合表型急性白血病,T/巨核细胞:它真的存在吗?
Neelum Mansoor1, Omer Javed2, Naila Rafiq3
1Department of Hematology & Blood Center, Indus Hospital & Health Network, Korangi Campus Plot C-76, Sector 31/5, Opposite Darussalam Society Korangi Crossing, Karachi, Pakistan. neelum.mansoor@tih.org.pk.
Journal of hematopathology
|January 4, 2024
概括
混合表型急性白血病 (MPAL) 是罕见的,并且难以诊断. 这项研究确定了T/巨核细胞MPAL,这是一种以前未定义的亚型,突出了其在世卫组织分类中列入的必要性.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 分子生物学分子生物学
背景情况:
- 混合表型急性白血病 (MPAL) 占急性白血病病例的不到4%,被世界卫生组织归类为罕见亚型.
- 在中低收入国家,诊断和治疗MPAL尤其具有挑战性.
- 虽然B/骨髓状和T/骨髓状MPAL相对较常见,但涉及大核细胞或红细胞系与其他细胞类型的组合异常罕见,并且通常不会在当前分类中得到解决.
研究的目的:
- 报告MPAL病例的临床表现,诊断概况和疾病过程,其双类型模式与T/巨核细胞系一致.
- 突出现有的世卫组织分类在解决罕见的MPAL亚型方面的局限性.
- 倡导将T/巨核细胞MPAL纳入世卫组织分类中作为一个独立的实体.
主要方法:
- 用8种颜色的流动细胞计与广泛的标记面板进行了表型鉴定.
- 用相间光在位杂交 (FISH) 来检测特定的基因重组 (BCR::ABL1,RUNX1::RUNX1T1,ETV6::RUNX1,MLL,CBFB).
- 通过使用自动化细胞成像系统进行了传统的GTG-banding karyotyping并进行了分析.
主要成果:
- 这项研究介绍了来自巴基斯坦的第一个T/巨核细胞MPAL病例.
- 这些病例符合T血统分配和急性巨核细胞白血病的标准.
- 这些发现强调了罕见MPAL亚型的诊断挑战和当前分类的局限性.
结论:
- /巨核细胞MPAL代表了一个独特的,以前未被定义的实体.
- 报告这种罕见病例对于积累关于临床表现,诊断和疾病过程的数据至关重要.
- 世卫组织的分类需要修订,以包括T/巨核细胞MPAL作为一个单独的类别,以改善诊断和管理.
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