RESUMO
La leucemia aguda es la enfermedad oncológica más frecuente en la infancia. La leucemia linfoblástica aguda representa el 75% y la mieloblástica aguda el 25% de ellas. La eritroleucemia es una entidad infrecuente, representando menos del 5% de las leucemias mieloblásticas agudas. Su definición ha variado a lo largo del tiempo. La OMS en 2017 define el subtipo de eritroleucemia cuando el porcentaje de eritroblastos representa el 80% de la celularidad total de la médula ósea. El presente trabajo, de tipo analítico, retrospectivo, tuvo como finalidad revisar los hallazgos de morfología, citometría de flujo, citogenética, respuesta al tratamiento y evolución de los casos previamente definidos como eritroleucemia, en nuestro centro, en los últimos 25 años y reclasificar aquellos que no cumplían con los nuevos criterios de la OMS 2017. Entre enero de 1990 y diciembre de 2015, se diagnosticaron 576 casos de leucemia mieloblástica aguda siendo 11 (1.9%) de ellos clasificados como eritroleucemia. Resultaron evaluables 10 casos. La distribución por sexo fue 1:1 y la edad mediana fue 5 (rango: 0.9-14) años. Seis pacientes presentaban antecedentes de síndrome mielodisplásico. Según los nuevos criterios, ninguno de los casos analizados puede ser actualmente definido como eritroleucemia. De acuerdo a la recategorización, fueron definidos como leucemias de subtipos de mal pronóstico, como leucemia aguda indiferenciada, sin diferenciación y megacarioblástica. Solo dos pacientes se encuentran libres de enfermedad, probablemente debido a estos subtipos desfavorables, sumado al antecedente frecuente de mielodisplasia.
Acute leukemia is the most frequent malignant disease in childhood. Acute lymphoblastic leukemia represents 75% and acute myeloblastic leukemia 25% of them. Erythroleukemia is a rare entity, corresponding to less than 5% of acute myeloblastic leukemia. Its definition has changed over the time. WHO in 2017 defines erythroleukemia when the percentage of erythroblasts represent 80% of the total cellularity of the bone marrow aspirate. This analytical and retrospective study was performed with the aim of reviewing morphology, flow cytometry and cytogenetic features, response to treatment and outcome of cases previously defined as erythroleukemia in our center during the last 25 years and, in addition to reclassify those cases which do not meet the new WHO 2017 criteria. From January 1990 to December 2015, 576 patients were diagnosed as acute myeloblastic leukemia and 11 (1.9%) of them were classified as erythroleukemia. Ten cases were evaluable. Sex distribution was 1:1 and the median age at diagnosis was 5 (range: 0.9-14) years. Six of them had presented with previous myelodysplastic syndrome. None of the analyzed cases can be currently defined as erythroleukemia, according to the new criteria. When reclassified, the cases were defined as leukemias of subsets with poor prognosis such as acute undifferentiated leukemia, without differentiation and megakaryoblastic leukemia. Only 2 patients remain leukemia-free and this could be explained both by the unfavorable prognosis of these leukemia subtypes, and the antecedent of myelodysplastic syndrome in most of the cases.
Assuntos
Humanos , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Organização Mundial da Saúde , Leucemia Eritroblástica Aguda/classificação , Leucemia Eritroblástica Aguda/diagnóstico , Argentina , Leucemia Eritroblástica Aguda/terapia , Estudos Retrospectivos , Resultado do Tratamento , Guias de Prática Clínica como Assunto , Progressão da Doença , Análise Citogenética/métodos , Citometria de Fluxo/métodosRESUMO
Acute leukemia is the most frequent malignant disease in childhood. Acute lymphoblastic leukemia represents 75% and acute myeloblastic leukemia 25% of them. Erythroleukemia is a rare entity, corresponding to less than 5% of acute myeloblastic leukemia. Its definition has changed over the time. WHO in 2017 defines erythroleukemia when the percentage of erythroblasts represent 80% of the total cellularity of the bone marrow aspirate. This analytical and retrospective study was performed with the aim of reviewing morphology, flow cytometry and cytogenetic features, response to treatment and outcome of cases previously defined as erythroleukemia in our center during the last 25 years and, in addition to reclassify those cases which do not meet the new WHO 2017 criteria. From January 1990 to December 2015, 576 patients were diagnosed as acute myeloblastic leukemia and 11 (1.9%) of them were classified as erythroleukemia. Ten cases were evaluable. Sex distribution was 1:1 and the median age at diagnosis was 5 (range: 0.9-14) years. Six of them had presented with previous myelodysplastic syndrome. None of the analyzed cases can be currently defined as erythroleukemia, according to the new criteria. When reclassified, the cases were defined as leukemias of subsets with poor prognosis such as acute undifferentiated leukemia, without differentiation and megakaryoblastic leukemia. Only 2 patients remain leukemia-free and this could be explained both by the unfavorable prognosis of these leukemia subtypes, and the antecedent of myelodysplastic syndrome in most of the cases.
Assuntos
Leucemia Eritroblástica Aguda/classificação , Leucemia Eritroblástica Aguda/diagnóstico , Organização Mundial da Saúde , Adolescente , Argentina , Criança , Pré-Escolar , Análise Citogenética/métodos , Progressão da Doença , Feminino , Citometria de Fluxo/métodos , Humanos , Lactente , Leucemia Eritroblástica Aguda/terapia , Masculino , Guias de Prática Clínica como Assunto , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Acute erythroid leukemia (AML M6) is a hematopoietic neoplasm frequently described in cats and mice, rarely in other animal species. This report describes a case of AML M6 in a yearling Thoroughbred filly. Clinically the horse presented marked pale mucous membranes and exercise intolerance. In addition, the owner and referring veterinarian reported a 30-day history of progressive weight loss. The CBC revealed severe anemia and leukopenia by neutropenia. Cytology evaluation obtained from bone marrow fine needle aspirates evidenced inversion of the myeloid: erythroid ratio (0.2), with 48% of the nucleated cells corresponding to rubriblasts. In addition to the gross evidence of anemia, necropsy findings consisted of splenomegaly and lymphadenomegaly. The diagnosis of AML M6B was confirmed histologically due to splenomegaly and lymphadenomegaly, secondary to neoplastic metastasization.(AU)
Leucemia eritroide aguda (LMA M6) é um neoplasia hematopoiética descrita com frequência em gatos e camundongos, mas raramente nas demais espécies de animais. Esse relato descreve um caso dessa doença em um equino, fêmea, Puro Sangue Inglês de um ano de idade. Clinicamente, o equino apresentou acentuada palidez das mucosas, intolerância ao exercício e o proprietário relatava emagrecimento progressivo. No hemograma, foi observada anemia grave e leucopenia por neutropenia. No mielograma, havia inversão da relação mieloide:eritroide (0,2) e 48% das células nucleadas da medula óssea correspondiam a rubriblastos. Na necropsia, além de evidências de anemia, havia esplenomegalia e linfadenomegalia. O diagnóstico de LMA M6B foi confirmado histologicamente e o aumento do baço e dos linfonodos foi decorrente de metastatização.(AU)
Assuntos
Animais , Feminino , Doenças dos Cavalos , Leucemia Eritroblástica Aguda/diagnóstico , Leucemia Eritroblástica Aguda/veterinária , Células Eritroides/patologiaRESUMO
New nanobiocomposites that combine nanoparticles and biomolecules have been shown very relevant for medical applications. Recently, cancer diagnostics and treatment have benefited from the development of nanobiocomposites, in which metallic or magnetic nanoparticles are conjugated with specific biomolecules for selective cell uptake. Despite recent advances in this area, the biomedical applications of these materials are still limited by the low efficiency of functionalization, low stability, among other factors. In this study, we report the synthesis of jacalin-conjugated gold nanoparticles, a nanoconjugate with potential application in medical areas, especially for cancer diagnosis. Jacalin is a lectin protein and it was employed due to its ability to recognize the Galß1-3GalNAc disaccharide, which is highly expressed in tumor cells. Gold nanoparticles (AuNPs) were synthesized in the presence of generation 4 polyamidoamine dendrimer (PAMAM G4) and conjugated with fluorescein isothiocyanate (FITC)-labeled jacalin. The AuNPs/jacalin nanoconjugates were characterized by transmission electron microscopy (TEM), dynamic light scattering (DLS) and vibrational spectroscopy (FTIR). We also performed an investigation using isothermal titration calorimetry (ITC) and fluorescence quenching measurements to understand the interactions occurring between the AuNPs and jacalin, which revealed that the nanoconjugate formation is driven by an entropic process with good affinity. Furthermore, in vitro tests revealed that the AuNPs/jacalin-FITC nanoconjugates exhibited higher affinity for leukemic K562 cells than for healthy mononuclear blood cells, which could be useful for biomedical applications, including cancer cells imaging.
Assuntos
Rastreamento de Células/métodos , Nanopartículas Metálicas/química , Lectinas de Plantas/química , Biomarcadores Tumorais , Dicroísmo Circular , Dendrímeros , Estabilidade de Medicamentos , Feminino , Fluoresceína-5-Isotiocianato , Corantes Fluorescentes , Ouro , Humanos , Células K562 , Leucemia Eritroblástica Aguda/diagnóstico , Leucócitos Mononucleares/citologia , Masculino , Nanopartículas Metálicas/ultraestrutura , Microscopia Eletrônica de Transmissão , Nanoconjugados/química , Nanoconjugados/ultraestrutura , Nylons , Espectrofotometria , Espectroscopia de Infravermelho com Transformada de Fourier , TermodinâmicaRESUMO
The effects of TPA (12-0-tetradecanoylphorbol-13-acetate) and RA (retinoic acid) were investigated on the cell lines HL60 (acute promyelocytic leukemia) and K562 (erythroleukemia) and on cells from patients with several kinds of leukemia. There were 14 cases of acute lymphocytic leukemia (ALL), 2 cases of chronic lymphocytic leukemia (CLL), 23 cases of acute myeloid leukemia (M1-M7), 5 cases of chronic myelocytic leukemia in blast crisis (CML-BC) and 2 mixed leukemias. In almost all of the cases examined, after TPA exposure cells from patients with proven myeloid leukemia became adherent to the substrate, while lymphoid leukemia cells remained in suspension, allowing the differentiation of lymphoid from myeloid blasts. The only exception was in one case of CLL, which had cells that became adherent with long filamental projections. In addition, increased phagocytosis following TPA exposure permitted characterization of M7 as this was the only myeloid leukemia negative for phagocytosis. Further discrimination between the subtypes of myeloid leukemia could be based on the increased lysozyme production seen after TPA in M4 and M5. Esterase positivity allowed the discrimination of M1 cells, which were negative before and after TPA treatment. In agreement with the results of other authors, TPA and RA led to independent ways of differentiation, granulocytic-like lineage and monocytic-like cells being favored by RA and TPA, respectively. The capacity of the same cell to differentiate into more than one lineage, depending on whether RA or TPA was used, was only seen in the present study with M3 cells.(ABSTRACT TRUNCATED AT 250 WORDS)