Acute Myelogenous Leukemia (FAB : MO) after Spontaneous Remission of Pancytopenia

A ten-month-old boy was admitted to our hospital for pancytopenia. On admission, his white blood cell count was 2, 630/, μl, his hemoglobin level was 7.4g/dl, and his platelet count was 16, 000/μl. The bone marrow examination showed 7.4% blastic cells. However, one month after the admission, the pan...

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Published inThe Japanese Journal of Pediatric Hematology Vol. 10; no. 1; pp. 42 - 45
Main Authors HIRAYAMA, Kiyotake, CHINA, Kohichiro, GUSHIKEN, Toshiki, HYAKUNA, Nobuyuki
Format Journal Article
LanguageJapanese
Published THE JAPANESE SOCIETY OF PEDIATRIC HEMATOLOGY/ONCOLOGY 1996
特定非営利活動法人 日本小児血液・がん学会
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ISSN0913-8706
1884-4723
DOI10.11412/jjph1987.10.42

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Abstract A ten-month-old boy was admitted to our hospital for pancytopenia. On admission, his white blood cell count was 2, 630/, μl, his hemoglobin level was 7.4g/dl, and his platelet count was 16, 000/μl. The bone marrow examination showed 7.4% blastic cells. However, one month after the admission, the pancytopenia was resolved and blastic cells in the bone marrow disappeared without specific treatment. One month after discharge, the patient was readmitted for a perianal abscess. On second admission, his white blood cell count was 6, 900/μl with 21% blastic cells. In the bone marrow, there were 26% blastic cells, which registered negative on the myeloperoxidase stain, but registered positive for CD13 and CD33. Chromosomal examination of blastic cells showed 47, XY, t (7 ; 12), + 19. Characteristically, 17% of the blastic cells were positive with platelet peroxidase. The diagnosis was MO according to the FAB classification. Complete remission was attained by chemotherapy with pirarubicin, vincristine and cytarabine. Spontaneous remission of pancytopenia before overt leukemia is unusual. Such a clinical course is similar to some cases of M7 leukemia. We suggest that some of M0 leukemia have similar findings of M7 leukemia.
AbstractList A ten-month-old boy was admitted to our hospital for pancytopenia. On admission, his white blood cell count was 2, 630/, μl, his hemoglobin level was 7.4g/dl, and his platelet count was 16, 000/μl. The bone marrow examination showed 7.4% blastic cells. However, one month after the admission, the pancytopenia was resolved and blastic cells in the bone marrow disappeared without specific treatment. One month after discharge, the patient was readmitted for a perianal abscess. On second admission, his white blood cell count was 6, 900/μl with 21% blastic cells. In the bone marrow, there were 26% blastic cells, which registered negative on the myeloperoxidase stain, but registered positive for CD13 and CD33. Chromosomal examination of blastic cells showed 47, XY, t (7 ; 12), + 19. Characteristically, 17% of the blastic cells were positive with platelet peroxidase. The diagnosis was MO according to the FAB classification. Complete remission was attained by chemotherapy with pirarubicin, vincristine and cytarabine. Spontaneous remission of pancytopenia before overt leukemia is unusual. Such a clinical course is similar to some cases of M7 leukemia. We suggest that some of M0 leukemia have similar findings of M7 leukemia.
A ten-month-old boy was admitted to our hospital for pancytopenia. On admission, his white blood cell count was 2, 630/, μl, his hemoglobin level was 7.4g/dl, and his platelet count was 16, 000/μl. The bone marrow examination showed 7.4% blastic cells. However, one month after the admission, the pancytopenia was resolved and blastic cells in the bone marrow disappeared without specific treatment. One month after discharge, the patient was readmitted for a perianal abscess. On second admission, his white blood cell count was 6, 900/μl with 21% blastic cells. In the bone marrow, there were 26% blastic cells, which registered negative on the myeloperoxidase stain, but registered positive for CD13 and CD33. Chromosomal examination of blastic cells showed 47, XY, t (7 ; 12), + 19. Characteristically, 17% of the blastic cells were positive with platelet peroxidase. The diagnosis was MO according to the FAB classification. Complete remission was attained by chemotherapy with pirarubicin, vincristine and cytarabine. Spontaneous remission of pancytopenia before overt leukemia is unusual. Such a clinical course is similar to some cases of M7 leukemia. We suggest that some of M0 leukemia have similar findings of M7 leukemia. 患児は11カ月の男児で, 生後10カ月時に汎白血球減少のため当科へ入院した.白血球数2,630/μl, 血色素7.4g/dl, 血小板数16,000/μlで, 骨髄中に芽球が7.4%みられた.汎血球減少は無治療で改善し, 骨髄中の芽球も消失した.1月後に肛門周囲膿瘍で, 当科へ再入院した.白血球数6,900/μlで芽球が21%認められた.骨髄中に芽球が26%みられた.芽球はmyeloperoxidase陰性で, 表面マーカーはCD7, CDl3, CD33が陽性であった.染色体の核型は47, XY, t (7;12), +19であった.FAB分類MOと診断し, pirarubicin, vincristine, cytarabineによる治療で寛解に導入できた. MOは, 新しい白血病の病型であり, 報告例が少ないためにその臨床像は不明な点が多い.本症例は, 汎白血球減少の自然寛解と芽球の消失後に白血病が発症しており, M7の臨床経過に類似していた.また本症例は芽球がPPO陽性で, M7の性状の一部を持つ病型と考えられた.
Author GUSHIKEN, Toshiki
CHINA, Kohichiro
HIRAYAMA, Kiyotake
HYAKUNA, Nobuyuki
Author_FL 百名 伸之
平山 清武
知名 耕一郎
具志堅 俊樹
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  fullname: HIRAYAMA, Kiyotake
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  fullname: HYAKUNA, Nobuyuki
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DocumentTitleAlternate 汎血球減少の自然寛解後に発症した急性骨髄性白血病(FAB:M0)の1例
DocumentTitle_FL 汎血球減少の自然寛解後に発症した急性骨髄性白血病(FAB:M0)の1例
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2) 角田三郎, 吉田稔 : 未分化白血/AML-M0の診断と治療の問題点.臨床血液35 : 238-244, 1994
4) Lee EJ, Pollak A, Leavitt RD, et al : Minimally differentiated acute nonlymphocytic leukemia : A distinct entity. Blood 70 : 1400-1406, 1987
3) Vesterhus P, Moe PL : Bone marrow dysfunction in a newborn twin with Down's syndrome. Clin Pediatr 13 : 347-349, 1974
5) Cadwell FJ, Burns CP, Dick FR, et al : Minimally differentiated acute leukemia. Leuk Res 17 : 199-208, 1992
6) 栗山一孝 : AMLの最小分化型M0.医学のあゆみ血液疾患, 溝口秀昭編医歯薬出版東京1993,148-150
References_xml – reference: 3) Vesterhus P, Moe PL : Bone marrow dysfunction in a newborn twin with Down's syndrome. Clin Pediatr 13 : 347-349, 1974
– reference: 4) Lee EJ, Pollak A, Leavitt RD, et al : Minimally differentiated acute nonlymphocytic leukemia : A distinct entity. Blood 70 : 1400-1406, 1987
– reference: 6) 栗山一孝 : AMLの最小分化型M0.医学のあゆみ血液疾患, 溝口秀昭編医歯薬出版東京1993,148-150
– reference: 1) Bennett JM, Catovsky D, Daniel M-T, et al : Proposal for the recognition of minimally differentiated acute myeloid leukemia (AML-MO). Br J Haematol 78 325-329, 1991
– reference: 5) Cadwell FJ, Burns CP, Dick FR, et al : Minimally differentiated acute leukemia. Leuk Res 17 : 199-208, 1992
– reference: 2) 角田三郎, 吉田稔 : 未分化白血/AML-M0の診断と治療の問題点.臨床血液35 : 238-244, 1994
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M0 leukemia
platelet peroxidase
spontaneous remission of pancytopenia
t (7; 12)
XY
Title Acute Myelogenous Leukemia (FAB : MO) after Spontaneous Remission of Pancytopenia
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