A cytological and histological study of acute premyelocytic leukaemia

Abstract

SYNOPSIS Among the acute leukaemias of the granulocytic group, acute premyelocytic leukaemia is distinguished by the severity of its haemorrhages, the frequency of hypofibrinaemia, a rapidly fatal course, and an unusual cellular hyperplasia. Myelograms show an increased proportion (average 80%) of characteristic cells of large diameter, with numerous azurophil granules. The infiltration of other organs is inconstant. MATERIAL AND METHODS Acute premyelocytic leukaemia represents about 6-8 % of all cases of acute leukaemia seen at our Institute (Bernard, Boiron, Weil, Levy, Seligmann, and Najean 1962). Between 1956 and August 1962, 34 cases of acute premyelocytic leukaemia from a total of 497 cases of acute leukaemia were seen. We have chosen for this study 25 cases followed up until death with, in 12 cases, a full necropsy. The diagnostic criterion used was the presence of a very large proportion of cells of the premyelocyte type (over 50% and often 80 to 100%) in the bone marrow, associated with the clinical and haematological features of acute leukaemia. Cytological studies were made on bone marrow and blood smears stained by the May-Grunwald-Giemsa method. The histological features of the bone marrow and various viscera obtained at necropsy were examined in tissues fixed in Bouin's fluid and stained with haematooxylin-phloxin-saffron. HAEMATOLOGICAL STUDY The clinical characteristics of acute premyelocytic leukaemia were first described in a previous communication (Bernard, Mathe, Boulay, Ceoara, and Chome, 1959). Table I presents the principal haematological data on the present series of cases. Anaemia was generally intense with a red cell count at first examination of under 21 million per c.mm. in 18 cases. The leucocyte count was variable, but often diminished (less than 5,000 c.mm. in 17 cases). Premyelocytes were found in the blood in 21 of the cases, but their number showed considerable individual variations. The myelogram as a rule

Central nervous system relapse in acute promyelocytic leukaemia in patients treated with all‐trans retinoic acid

“…Although there have been several case reports, its incidence is somewhat uncertain in the absence of cytogenetic and/or molecular confirmation of the diagnosis in many earlier studies. For example, Bernard et al (1963) reported two cases of CNS relapse amongst 25 patients with morphological APL. More recent larger studies, which also predate the advent of the widespread use of ATRA, such as the UK MRC AML X Trial, have established the rarity of CNS relapse in patients with a clinical diagnosis of APL.…”

Acute Myeloid Leukemia with Giant Inclusions: Cytochemical and Ultrastructural Study

“…The char acteristic giant granules seen have cytochemical and ultrastructural similarities with the inclusion bodies of the CHS [5,6,9,16,25,34], We can surmise whether there is any re lation between the absence of biologic symptoms of DIC in our case report and the absence of any crystalline structure in abnormal granules and ABs. In fact, several workers have reported that the DIC is closely associated with the abund ance of intracellular ABs [4,11,15,27]. On the other hand, many ultrastructural stud ies have demonstrated a periodicity and crystalline structure in ABs [5,7], Tulliez and Breton-Gorius [31] suggested that the DIC was associated with the pres ence of types I and 111 ABs related to some crystallized proteins that may act upon coagulation.…”

Routine isolation of the 70 S RNA of a murine oncornavirus by use of an unesterified cellulose column

“…MSV-MLV virus was obtained from the supernatant fluids of a chronically infected line (78Al cell line) [6]. It was labeled and purified as described elsewhere [7] .…”