title: Trilineage acute leukaemia in combined Ph1-chromosome positivity and monosomy 7.
abstract: A case of acute leukaemia with Ph1-chromosome and monosomy 7 is reported, in which the peripheral blood contained three types of blast cell as distinguished by light and electron microscopy and immunological phenotyping. The first blast-cell type originated from the granulocytic lineage; the cells contained peroxidase-positive granules, and had an HLA-DR+Tdt-CALLA-phenotype. The second blast-cell type was more difficult to define, but had many characteristics of the monocytic series. The phenotype of these blast cells was HLA-DR+Tdt-CALLA-BA-2+ or HLA-DR+/-TA-1+63D3+. Finally, the third type of blast cell was clearly of lymphocytic origin. These cells were peroxidase-negative, and were CALLA+ as studied by electron microscopy using immunogold labelling and fluorescence microscopy. Their phenotype was HLA-DR+Tdt+CALLA+. Cell sorting and double fluorescence assays showed that these three populations were separate; no cells of mixed myeloid/lymphoid phenotype were found. This case suggests the neoplastic transformation of an immature progenitor cell and subsequent differentiation of the neoplastic cells in various directions.
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000941:Antigens / Q000032:analysis; D000951:Antigens, Neoplasm / Q000032:analysis; D002462:Cell Membrane / Q000473:pathology; D002467:Cell Nucleus / Q000473:pathology; D002872:Chromosome Deletion; D002904:Chromosomes, Human, 21-22 and Y; D002906:Chromosomes, Human, 6-12 and X; D003593:Cytoplasm / Q000473:pathology; D005260:Female; D006098:Granulocytes / Q000276:immunology / Q000473:pathology; D006684:HLA-DR Antigens; D006412:Hematopoietic Stem Cells / Q000473:pathology; D000949:Histocompatibility Antigens Class II / Q000032:analysis; D006801:Humans; D007527:Isoenzymes / Q000032:analysis; D007938:Leukemia / Q000235:genetics / Q000473:pathology*; D008214:Lymphocytes / Q000276:immunology / Q000473:pathology; D008854:Microscopy, Electron; D009000:Monocytes / Q000276:immunology / Q000473:pathology; D009006:Monosomy; D015260:Neprilysin; D009195:Peroxidase; D010544:Peroxidases / Q000032:analysis; D010641:Phenotype
chemical_list: D000941:Antigens; D000951:Antigens, Neoplasm; D006684:HLA-DR Antigens; D000949:Histocompatibility Antigens Class II; D007527:Isoenzymes; D010544:Peroxidases; D009195:Peroxidase; D015260:Neprilysin