Lineage infidelity in chronic myeloid leukemia
Virchows Archiv B Cell Pathology Including Molecular Pathology(1986)
Abstract
Summary Blood smears from 13 cases of chronic myeloid leukemia (CML) were examined for bigranulated (basophil/eosinophil) cells. The
cells were stained with May-Grünwald-Giemsa, toluidine blue, Biebrich scarlet, Adams’ reaction, and were reacted for KCN-resistant
peroxidase in two cases. A sequential stain (toluidine blue/Biebrich scarlet/Adams’ reaction) was applied to 50 cells in each
case. Hybridoid cells occurred in all cases with varying frequency. Double granulation was not only found in immature, non-segmented
cells but often in mature segmented cells. The chimeric cells were difficult to detect with May-Grünwald-Giemsa. Biebrich
scarlet and Adams’ reaction identified differing quantities of these cells, Adams’ reaction being superior in this respect
to Biebrich scarlet. Some granules that were positive by Adams’ reaction did not stain with Biebrich scarlet. This is in sharp
contrast to the normal and is, therefore, interpreted as a granule atypicality. Since under normal circumstances, eosinophilic
and basophilic granules can be viewed as mutually exclusive markers of the respective granulocytic lineages, the simultaneous
occurrence in CML cells of both markers demonstrates lineage infidelity. Until now lineage infidelity has been reported only
in immature cells. However, our results show that lineage infidelity also occurs in mature segmented cells. This indicates
that the progenitors of these chimeric granulocytes follow false genetic programs producing cells with profound irreversible
neoplastic aberrations.
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Key words
Lineage infidelity,Chronic myeloid leukemia,Bigranulated leukocytes,Cytochemistry
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