title: Immunophenotypic characterisation of acute leukaemia after polycythemia vera.
abstract: OBJECTIVE
  To analyze the immunophenotype of blast cells in patients with acute leukaemia after polycythemia vera, together with the most relevant clinical and haematological disease characteristics.
  
  
  METHODS
  The immunophenotype was analysed in nine patients by immunofluorescence flow cytometry using a panel of 15 monoclonal antibodies. The DNA content of blast cells was determined using Vindelov's technique.
  
  
  RESULTS
  The most relevant clinical and haematological disease characteristics included: the presence of enlarged spleen and liver by 56% and 67%, respectively; a moderate degree of leucocytosis with thrombocytopenia while haemoglobin was normal in 50% of patients. All patients received alkylating agents or hydroxyurea, or both. Interestingly, the chronic phase in patients receiving this latter drug was shorter. All cases showed a myeloid phenotype, four of them reactive only to early myeloid antigens (CD13/33); in the remaining cases the blast cells displayed granulomonocytic (CD14+, CD15+), erythroid (CD71 ), or megakaryocytic (CD61+, CD41+) markers. Coexpression of lymphoid related antigens (CD7, TdT, or CD19) was also detected. The morphological assessment of blast cells agreed with the immunophenotyping in five out of the nine cases. Blast cells from all six patients analysed displayed a diploid DNA content and the proportion of S-phase cells ranged from 0.4% to 4%.
  
  
  CONCLUSIONS
  These findings suggest a pluripotential stem cell with myeloid commitment as the target cell of acute leukaemia after polycythemia vera.
authors.affiliation: Servico de Hematología, Hospital Clínico Universitario, Salamanca, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Hernández
authors.forename: A
authors.initials: A
authors.lastname: Orfao
authors.forename: M
authors.initials: M
authors.lastname: González
authors.forename: B
authors.initials: B
authors.lastname: Cuesta
authors.forename: M C
authors.initials: MC
authors.lastname: López-Berges
authors.forename: M C
authors.initials: MC
authors.lastname: Cañizo
authors.forename: J
authors.initials: J
authors.lastname: Ciudad
authors.forename: J F
authors.initials: JF
authors.lastname: San Miguel
mesh_terms: D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000032:analysis*; D015214:Antigens, Differentiation, Myelomonocytic / Q000032:analysis; D002453:Cell Cycle; D004273:DNA, Neoplasm / Q000032:analysis; D004171:Diploidy; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016130:Immunophenotyping; D015470:Leukemia, Myeloid, Acute / Q000276:immunology* / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011087:Polycythemia Vera / Q000473:pathology*
chemical_list: D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D004273:DNA, Neoplasm