Abstract
In the period from January to May 1987, leukemic cell surface marker analysis were performed in 34 cases with acute lymphoblastic leukemia (ALL) by using lymphocyte associated antibodies (J5, B1, B4, Leu-1, and Leu-9) and granulocyte associated antibodies (Mo1, Mo2, My4, My7, MCS-2 and My9).
Six of 34 patients with ALL were diagnosed ”acute mixed lineage leukemia (AMLL)” of Mirro's proposal, which expressed both lymphoid and myeloid antigens. However, the leukemic cells of this group were strongly expressed lymphoid associated antigens (J5, B4, I2) more than granulocyte associated antigens, and there were no difference in cell morphology and biochemical stains between AMLL and ALL.
The reactivity of blast cells against granulocyte associated antibodies were following; case 1: My7+, My9+, case 2: MCS-2+, My7+, My9+, case 3: Mo1+, Mo2+, MCS-2+, My7+, case 4: MCS-2+, My7+, My9+, case 5: MCS-2+, My7+, My9+, case 6: MCS-2+, My7+. From analysis of the fluorescein histogram of flow cytometry, it was recognized that the fluorescein intensity of granulocyte associated antigens on their blast cells and the percentage of the positive cells were very weak and low.
Two color analysis by flow cytometry confirmed that the blast cells from three patients (case 1, 2, 5) were simmultaneusly expressing J5 and My7 antigens. one case (case 6) had two different cell marker population; 7% blast cells showed dual strong expression of J5 and My7 antigens, and 57% blast cells showed expression of only My7 but J5 antigen.
Four fresch diagnosed patients achieved easily complete remission with conventional induction chemotherapy for ALL.
Cinical and biological significance of ”AMLL” have not clear yet. Further studies are necessary to define clinical characters of AMLL.
