PMID- 19500135
OWN - NLM
STAT- MEDLINE
DCOM- 20091022
LR  - 20090917
IS  - 1600-0609 (Electronic)
IS  - 0902-4441 (Linking)
VI  - 83
IP  - 4
DP  - 2009 Oct
TI  - The role of peripheral blood, bone marrow aspirate and especially bone marrow 
      trephine biopsy in distinguishing atypical chronic myeloid leukemia from chronic 
      granulocytic leukemia and chronic myelomonocytic leukemia.
PG  - 292-301
LID - 10.1111/j.1600-0609.2009.01283.x [doi]
AB  - OBJECTIVES: To better realize the features of peripheral blood (PB), bone marrow 
      (BM) aspirate and especially BM trephine biopsy in atypical chronic myeloid 
      leukemia (aCML). METHODS: We studied PB, BM smears in 35 cases of aCML and 
      compared with 84 cases of chronic granulocytic leukemia chronic phase (CGL-CP), 
      39 cases of chronic myelomonocytic leukemia (CMML). In addition, we evaluated 
      characteristics of BM trephine biopsies in 21 cases of aCML and compared with 68 
      cases of CGL-CP, 20 cases of CMML. RESULTS: All aCML patients presented with 
      leukocytosis (median WBC 17.3 x 10(9)/L), 48% had moderate anemia, and 85% had 
      thrombocytopenia. Values of monocytes, eosinophils, basophils, percentage of 
      immature granulocytes and monocytes (0.63 +/- 0.41 x 10(9)/L, 0.18 +/- 0.16 x 
      10(9)/L, 0.09 +/-0.08 x 10(9)/L, 6.27 +/- 3.09%, and 2.46 +/- 1.75%, 
      respectively) were useful in distinguishing aCML from CGL-CP and CMML groups. The 
      BM smears showed that striking dysgranulopoieis (100%), dyserythropoiesis 
      (48.6%), percentage of blasts, nucleated erythrocytes, monocytes, eosinophils, 
      and basophils (2.45 +/- 2.06%, 7.76 +/- 2.89%, 1.30 +/- 1.21%, 1.47 +/- 1.60%, 
      and 1.15 +/- 1.08%, respectively) were all important parameters for a diagnosis 
      of aCML. On BM trephine sections, aCML was characterized as hypercellularity, a 
      moderate degree of reticulin fibrosis (71.4%), lymphocytopenia (76.2%), 
      plasmacytopenia (90.5%), abnormal localization of immature precursors (28.5%), 
      and absence of eosinophilia, basophilia, monocytosis. Furthermore, BM imprints, 
      immunohistochemical, and cytochemical staining findings provided important 
      morphological reference to BM trephine sections and made the identification of 
      nucleated cells more convenient. CONCLUSIONS: Besides the findings observed in PB 
      and BM aspirate, features of BM trephine biopsy (including BM trephine section, 
      BM imprint, immunohistochemical, and cytochemical staining) can also aid in the 
      diagnosis of aCML.
FAU - Xubo, Gong
AU  - Xubo G
AD  - Departments of Hematology , The Second Affiliated Hospital, School of Medicine, 
      Zhejiang University, Hangzhou, China.
FAU - Xingguo, Lu
AU  - Xingguo L
FAU - Xianguo, Wu
AU  - Xianguo W
FAU - Rongzhen, Xu
AU  - Rongzhen X
FAU - Xibin, Xiao
AU  - Xibin X
FAU - Lin, Wang
AU  - Lin W
FAU - Lei, Zhu
AU  - Lei Z
FAU - Xiaohong, Zhang
AU  - Xiaohong Z
FAU - Genbo, Xu
AU  - Genbo X
FAU - Xiaoying, Zhao
AU  - Xiaoying Z
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20090602
PL  - England
TA  - Eur J Haematol
JT  - European journal of haematology
JID - 8703985
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Biopsy
MH  - Blood Cells/*pathology
MH  - Bone Marrow/*pathology
MH  - Bone Marrow Examination
MH  - Diagnosis, Differential
MH  - Female
MH  - Histocytochemistry
MH  - Humans
MH  - Immunohistochemistry
MH  - Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
MH  - Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative/*diagnosis
MH  - Leukemia, Myelomonocytic, Chronic/diagnosis
MH  - Male
MH  - Middle Aged
EDAT- 2009/06/09 09:00
MHDA- 2009/10/23 06:00
CRDT- 2009/06/09 09:00
PHST- 2009/06/09 09:00 [entrez]
PHST- 2009/06/09 09:00 [pubmed]
PHST- 2009/10/23 06:00 [medline]
AID - EJH1283 [pii]
AID - 10.1111/j.1600-0609.2009.01283.x [doi]
PST - ppublish
SO  - Eur J Haematol. 2009 Oct;83(4):292-301. doi: 10.1111/j.1600-0609.2009.01283.x. 
      Epub 2009 Jun 2.