Features separate forms lymphoblastic leukemia
Acute undifferentiated leukemia (M0): blastic cells in blood 20-97%, the number of neutrophils ranged from 2 to 60% of lymphocytes - from 0 to 75%.The possible bone marrow hyperplasia total blast cells, and the reduction of red blood megakaryocytopoiesis.Blast cells differ large polymorphism found macro- and meso 12-14-20 nm in diameter.
Acute myeloid (M1, M2) and myeloblastic (M4) leukemias are almost identical morphological characteristics, and do not differ in the clinical picture of the disease.They account for 62-73% of all OnLL.However, acute myeloblastic leukemia can be represented blast cells belonging to mieloblas-monoblast there, but more often blasts in this form of leukemia have symptoms like cytochemical monocytic and granulocytic series.The frequency of remission in acute myeloid leukemia and myeloblastic in modern therapy is 60-80% [Vladimir EBet al., 1998].Duration of remission up to 12-24 months and the length of life of patients can exceed 3 years.In 10% of cases, there is recovery.
Acute promyelocytic leukemia (M3).The cell substrate of this form of leukemia blasts up, characterized by abundant azurophilic grit and reminding promyelocytes.The blasts are large (15-20 nm) and large eccentrically located nucleus irregularly shaped, sometimes bipartite, delicate chromatin structure.Nucleoli in the nucleus are not always clearly demarcated.The number of blast cells containing azurophil grain is at least 50%.It is believed that if the grain is found in 30-40% blasts and more - is promyelocytic leukemia, if less than 20% - myelogenous.There are cytoplasmic outgrowths, which are devoid of granules.Cytoplasmic basophilia expressed to varying degrees.In the red bone marrow infiltration promyelocytic point total.The number of blasts in the blood is 40-85% [Morozova VT 1977].Erythropoiesis-tsitopoez megakario and sharply oppressed.Acute promyelocytic leukemia observed in 10.5% of cases OnLL.The clinical picture of the disease is characterized by severe hemorrhagic syndrome, which appears in the background of moderate thrombocytopenia (20-100h109 / l).The development of hemorrhagic syndrome caused
ICE, as well as the release of heparin substances of leukemic cells.
Acute erythroleukemia (Di Guglielmo's disease, M6) - a rare form of leukemia (5% of all OnLL).Changes in the bone marrow punctate not different from M2.Blood picture at the beginning of the disease can be aleukemic, but as the disease begins leukemization: the blood out erythrokaryocytes and / or blasts.Anemia usually moderately hyperchromic, normoblasts detected in blood, reticulocytes are less than 1%.Leukopenia and thrombocytopenia sometimes develop in the very beginning of the disease.