FEATURES OF A DIFFERENTIAL DIAGNOSIS OF PEDIATRIC ACUTE MONOCYTIC LEUKEMIA (AML-M5a) ON THE EXAMPLE OF A CLINICAL CASE

O. Kit, N. Guskova, O. Selyutina, V. V. Dmitrieva, I. Novikova, I. S. Torpujyan, V. Zakharchenko
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引用次数: 2

Abstract

The aim of this work was to assess the significance of investigating clinical and laboratory parameters for diagnosing acute monocytic leukemia in children on the basis of a clinical case. The article demonstrates specific features of differentiating AML M5a from other forms of acute myeloid leukemia. According to the results of hematological, morphological and cytofluorimetric studies of blood and bone marrow samples, the diagnosis of acute myeloid leukemia was established. The morphological and phenotypic characteristics of blast cells hampered the diagnosis of an AML form. However, a comprehensive analysis of the expressed CD antigens allowed acute monocytic leukemia to be identified, which diagnosis was subsequently confirmed by a cytochemical study. Thus, the clinical diagnosis was established over a short period of time. This was of importance given the rising severity of the patient’s condition requiring immediate treatment, the initial hyperleukocytosis and the development of life-threatening complications associated with leukostasis in the lungs and the central nervous system. In the presented case, the clinical manifestations of the underlying disease and the results of flow cytofluorimetry were determining factors in initiating timely specific therapy.
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小儿急性单核细胞白血病(AML-M5a)的鉴别诊断:以一例临床病例为例
这项工作的目的是评估调查临床和实验室参数诊断急性单核细胞白血病在儿童临床病例的基础上的意义。本文阐述了AML M5a与其他形式的急性髓系白血病鉴别的具体特征。根据血液和骨髓标本的血液学、形态学和细胞荧光学研究结果,建立急性髓性白血病的诊断。胚细胞的形态学和表型特征阻碍了AML的诊断。然而,对表达的CD抗原进行全面分析,可以确定急性单核细胞白血病,随后通过细胞化学研究证实了诊断。因此,临床诊断是在短时间内建立的。考虑到患者病情的日益严重,需要立即治疗,最初的白细胞增多和肺部和中枢神经系统白细胞淤积相关的危及生命的并发症的发展,这一点很重要。在本病例中,潜在疾病的临床表现和流式细胞荧光法的结果是及时启动特异性治疗的决定性因素。
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