Dual-color flow cytometric analysis of megakaryocytic DNA ploidy in the investigation of blastic phase chronic myelogenous leukemia with rearrangement of 3q26.
A patient is described with chronic myelogenous leukemia in blastic crisis, in whom numerous circulating platelet fragments and megakaryocytic nuclei were present, with 50% blasts and 50% micromegakaryocytes in the marrow. The blasts expressed myeloid-associated antigens CD34, CD33, and CD13, whereas the micromegakaryocytes were positive for CD41, CD42b, and CD61. These findings suggested a myeloblastic transformation with a possible megakaryoblastic component. Cytogenetic analysis showed rearrangement of 3q26 in the form of t(2;3) (p13;q26), in addition to t(9;22) (q34;q11). Dual-color flow cytometric analysis of DNA content of CD42b-positive cells showed that the micromegakaryocytes were predominantly 2N, indicating a maturation block before nuclear endoreplication and polyploidization. These findings confirmed a combined myeloblastic and megakaryoblastic transformation. It is concluded that dual-color flow cytometric DNA analysis is a useful method for the investigation of abnormal megakaryocytopoiesis in hematologic malignancies.
University Department of Medicine, Queen Mary Hospital, Hong Kong.
Y L
YL
Kwong
E P
EP
Robertson
C P
CP
Lee
L C
LC
Chan
D000328:Adult; D001853:Bone Marrow / Q000473:pathology; D002466:Cell Nucleolus / Q000648:ultrastructure; D002467:Cell Nucleus / Q000648:ultrastructure; D002893:Chromosomes, Human, Pair 3; D003593:Cytoplasm / Q000648:ultrastructure; D004273:DNA, Neoplasm / Q000235:genetics*; D004171:Diploidy; D005260:Female; D005434:Flow Cytometry; D015321:Gene Rearrangement; D006801:Humans; D016130:Immunophenotyping; D015466:Leukemia, Myeloid, Chronic-Phase / Q000235:genetics* / Q000473:pathology*; D008533:Megakaryocytes / Q000378:metabolism / Q000473:pathology*; D011003:Ploidies; D011123:Polyploidy
D004273:DNA, Neoplasm