[A female patient with near-tetraploid acute myeloid M4 leukemia].
BACKGROUND
Acute myeloid leukemias (AML) are a heterogeneous group of diseases, several types of them are well characterized by typical morphologic, immunologic and cytogenetic features of their leukemic blasts in the MIC classification. We have recently described 2 patients with a new AML type--poorly differentiated near-tetraploid AML L0. The occurrence of very large blasts in a heterogeneous blast population seemed to be a morphological sign of this new type of AML.


RESULTS
The same morphologic characteristics were observed by us when we studied blasts of another 80-year-old patient with a near-tetraploid karyotype. However, 34% of blasts were positive for myeloperoxidase and they exhibited in 24-33% surface myelomonocytic markers CD11b, CD13, CD15 and CD14. The illness was classified as acute myelomonoblastic leukemia M4 without significant dysplastic changes in erythroid and megakaryocytic lineages. The growth of granulocyte-macrophage bone marrow progenitors CFU-GM was low. The patient refused cytotoxic chemotherapy and expired 3 months later on supportive treatment.


CONCLUSIONS
The finding of very large blasts is a typical sign in cases of near-tetraploid AML. Precise classification of leukemia type is essential for successful therapy.
Lemez
P
P
Ustav hematologie a krevní transfuze, Praha.
Michalová
K
K
Jelínek
J
J
Janousek
J
J
Marinov
I
I
Burjanková
J
J
Skuhrovcová
I
I
Rysková
P
P
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015479:Leukemia, Myelomonocytic, Acute / Q000235:genetics*; D011123:Polyploidy
Nemocná s témĕr tetraploidní akutní myeloidní leukémií M4.