title: Hypergranular acute lymphoblastic leukemia (ALL). Report of a case and review of the literature.
abstract: We report a case of adult acute lymphoblastic leukemia (ALL) with myeloid-like hypergranulation of blast cells. Like most of the "granular" ALLs described in the literature, the blast cells had L2 morphology and exhibited a common-ALL immunologic phenotype. The clinical findings at diagnosis were unremarkable. Cytogenetic analysis showed a 46XY karyotype. Molecular genetic analysis revealed T-cell receptor (TCR) gamma and immunoglobulin heavy chain rearrangements; no rearrangement was found at the TCR beta gene locus. The polymerase chain reaction (PCR) for the BCR-ABL translocation was negative. The clinical course of the patient was uncomplicated. On standard ALL treatment protocol he achieved complete remission (CR) within 4 weeks, and he is currently disease free 8 months after diagnosis. The case contributes well-documented data to the characterization of adult "granular" ALL, with special regard to changes at the molecular genetic level.
authors.affiliation: Clinical Institute for Medical, University of Vienna, Austria.
authors.forename: I
authors.initials: I
authors.lastname: Schwarzinger
authors.forename: M
authors.initials: M
authors.lastname: Födinger
authors.forename: R
authors.initials: R
authors.lastname: Scherrer
authors.forename: M
authors.initials: M
authors.lastname: Wolzt
authors.forename: C
authors.initials: C
authors.lastname: Mannhalter
authors.forename: W
authors.initials: W
authors.lastname: Speiser
mesh_terms: D000328:Adult; D015703:Antigens, CD / Q000032:analysis; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001752:Blast Crisis / Q000473:pathology; D001761:Bleomycin / Q000008:administration & dosage; D001853:Bone Marrow / Q000473:pathology*; D015321:Gene Rearrangement; D005803:Genes, Immunoglobulin; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D016133:Polymerase Chain Reaction; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood* / Q000235:genetics / Q000276:immunology / Q000473:pathology*; D016693:Receptors, Antigen, T-Cell, alpha-beta / Q000235:genetics; D016692:Receptors, Antigen, T-Cell, gamma-delta / Q000235:genetics; D015183:Restriction Mapping; D005641:Tegafur / Q000008:administration & dosage
chemical_list: D015703:Antigens, CD; D007143:Immunoglobulin Heavy Chains; D016693:Receptors, Antigen, T-Cell, alpha-beta; D016692:Receptors, Antigen, T-Cell, gamma-delta; D001761:Bleomycin; D005641:Tegafur; D008727:Methotrexate