title: Significance of transmission electron microscopy in subtyping of monocytic leukemia.
abstract: The objective of this paper is to produce an ultrastructural classification of acute monocytic leukemia (AML-M5) in relation to clinical behaviors. The ultrastructural characteristics of blasts of the monocytic series were analyzed in 72 M5 patients by transmission electron microscopy (TEM), in terms of their content of typical monoblasts, atypical monoblasts, atypical promonocytes, and typical promonocytes in bone-marrow aspirates. Four kinds of monocytic blasts were identified by cell size and shape, nuclear profile, nucleocytoplasmic ratio, heterochromatin content, nucleolus, granules, vesicles, and Golgi apparatus. Their characteristics of remission rate, cytochemistry, immunophenotype, and cytogenetics were also investigated. The data obtained permitted M5 patients to be divided into monoblast and promonocyte types. Monoblast-type patients expressed weaker monocytic enzymograms and specific antigen staining for CD14 and CD64, compared with promonocyte-type patients. Monoblast patients had higher CR than promonocyte patients. Therefore, TEM subclassification of patients differs from and improves upon the light microscopical criteria for distinguishing monoblasts and promonocytes and has clinical significance.
authors.affiliation: Institute of Hematology & Blood Diseases Hospital, State Key Laboratory of Experimental Hematology, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China. ruyongxin@126.com
authors.forename: Yong-Xin
authors.initials: YX
authors.lastname: Ru
authors.forename: Yin-Chang
authors.initials: YC
authors.lastname: Mi
authors.forename: Jin-Hua
authors.initials: JH
authors.lastname: Liu
authors.forename: Hui-Jun
authors.initials: HJ
authors.lastname: Wang
authors.forename: Shi-Xuan
authors.initials: SX
authors.lastname: Zhao
authors.forename: Wen
authors.initials: W
authors.lastname: Cui
authors.forename: Cheng-Wen
authors.initials: CW
authors.lastname: Li
authors.forename: Qing-Hua
authors.initials: QH
authors.lastname: Li
authors.forename: Xiao-Fan
authors.initials: XF
authors.lastname: Zhu
authors.forename: Zhi-Jian
authors.initials: ZJ
authors.lastname: Xiao
authors.forename: Jian-Xiang
authors.initials: JX
authors.lastname: Pang
authors.forename: Jian-Xiang
authors.initials: JX
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001854:Bone Marrow Cells / Q000648:ultrastructure; D002467:Cell Nucleus / Q000648:ultrastructure; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016130:Immunophenotyping / Q000379:methods*; D007621:Karyotyping; D007948:Leukemia, Monocytic, Acute / Q000145:classification* / Q000175:diagnosis; D008297:Male; D046529:Microscopy, Electron, Transmission / Q000379:methods*; D008875:Middle Aged; D055017:Monocyte-Macrophage Precursor Cells / Q000201:enzymology / Q000648:ultrastructure*; D015388:Organelles / Q000648:ultrastructure; D009195:Peroxidase / Q000378:metabolism; D055815:Young Adult
chemical_list: D009195:Peroxidase