Identification of myeloid origin in undifferentiated congenital leukemia by in vitro marrow culture study.
A case of congenital leukemia that originally did not express any lineage-specific antigenic markers is presented. The blast cell morphologic appearance was L1 according to French-American-British (FAB) classification and showed lymphoid characteristics by cytochemical staining and transmission electron microscopy. However, immunophenotyping using a variety of monoclonal antibodies did not confirm the lymphoid origin. Furthermore, the immunoglobulin heavy chain and T-cell receptor beta-chain genes were in germ-line configuration. The in vitro culture study defined the leukemia as of myeloid origin. The semisolid methylcellulose culture showed an acute non-lymphocytic leukemia-type growth pattern. Bone marrow blasts underwent myeloid differentiation with positive myeloperoxidase and butyrate esterase activity during a suspension culture. These findings indicate that this case represents an acute undifferentiated leukemia that has probably arisen from the malignant transformation of stem cells of myeloid progeny.
Division of Hematology/Oncology, Shizuoka Children's Hospital, Japan.
S
S
Kojima
J
J
Mimaya
T
T
Tonouchi
M
M
Eguchi
H
H
Osada
R
R
Ueda
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001853:Bone Marrow / Q000648:ultrastructure*; D002478:Cells, Cultured; D004253:DNA Nucleotidylexotransferase / Q000378:metabolism; D005260:Female; D015321:Gene Rearrangement; D015329:Gene Rearrangement, T-Lymphocyte; D006801:Humans; D007136:Immunoglobulins / Q000235:genetics; D007223:Infant; D007951:Leukemia, Myeloid / Q000151:congenital / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics; D008565:Membrane Proteins / Q000032:analysis; D008854:Microscopy, Electron; D014410:Tumor Stem Cell Assay
D007136:Immunoglobulins; D008565:Membrane Proteins; D004253:DNA Nucleotidylexotransferase