A Case of T-ALL Indicating Characteristics of Megakaryocyte Lineage at Relapse.
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In this report, we present a 14-year-old girl with T-ALL transforming to acute megakaryoblastic leukemia (AMKL). She presented in October 1986 with complaint of arthralgia on both ankles. Her white blood cell count was 2, 900/μl with five percent blast cells, and bone marrow examination showed 76.4 percent of blast cells. These blast cells expressed CD2, CD3, and CD8 antigens and were positive for E-rosette test. The patient was diagnosed as having T-ALL. She was treated with vincristine, L-asparaginase, prednisolone, daunorubicin, and cyclophosphamide and attained complete remission. However, a relapse on left breast occurred in July 1989. On immunocytochemical staining, blast cells expressed T cell associated antigens. Although this tumor on left breast regressed after chemotherapy, a relapse in bone marrow and breast occurred in May 1991. Blast cells sampled from bone marrow expressed CD11b, CD33, and HLA-DR antigens. On examination using electronmicroscope, these blast cells had platelet peroxidase activity. She was diagnosed as having AMKL. Although she was treated with doxorubicin and Ara-C, she died of pneumonia in July 1991. This case had characteristics of both T cell and megakaryocyte lineage, indicating that there were multilineage progenitor cells which could differentiate to both T lymphocyte and megakaryocyte.
- 特定非営利活動法人 日本小児血液・がん学会の論文
特定非営利活動法人 日本小児血液・がん学会 | 論文
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