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Under the present conditions, the competitive capacity of a health care facility is provided by the high level and timeliness of diagnosis of disease. The diagnosis of the types of acute leukemia (AL) may be accomplished immunologically, by using a 33-marker panel and without consideration of the morphocytochemical parameters of blast cells. But such an approach complicates and prolongs the examination of patients with AL.

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Type I MOZ/CBP (MYST3/CREBBP) is the most common chimeric transcript in acute myeloid leukemia with t(8;16)(p11;p13) translocation.

Genes Chromosomes Cancer

June 2004

Hematopathology Unit, Department of Pathology, Postgraduate School of Hematology Farreras-Valentí, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain.

The t(8;16)(p11;p13) fuses the MOZ (MYST3) gene at 8p11 with CBP (CREBBP) at 16p13 and is associated with an infrequent but well-defined type of acute myeloid leukemia (AML) that has unique morphocytochemical findings (monocytoid blast morphology with erythrophagocytosis and simultaneously positive for myeloperoxidase and nonspecific esterases). RT-PCR amplification of MOZ/CBP (MYST3/CREBBP) chimera has proved difficult, with four different transcripts found in four reported cases. We studied 7 AML-t(8;16) patients, 5 with cytogenetically demonstrated t(8;16) and 2 with similar morphocytochemical and immunophenotypical characteristics.

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Twelve intricate cases with different variants of acute leukemia were diagnosed by morphocytochemical and immunological methods. In six patients with initially diagnosed acute lymphoblastic leukemia (ALL) comprehensive studies revealed acute myelomonoblastic leukemia (AMML), in four ALL patients AML(M1,M0) and AMML were diagnosed, and in two patients with AML B-lymphoblastic lymphoma/leukemia was detected. These data indicate that immunophenotyping methods in complex with morphological and cytochemical studies helped correctly diagnose the disease variants, particularly in cases difficult to diagnose.

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Previous morphocytochemical, immunological and cytogenetic analyses of blast cells in 174 children and 188 adults admitted to Cancer Research Center have shown that compared to adults in children leukemic precursors belong to earlier stage of differentiation similar to polypotent cell. The analysis covered 2 FAB-variants of ANLL comparable by the number of patients and intensity of the given chemotherapy (M2 and M4 ANLL FAB variants). The study included 65 children (50 with M2 and 15 with M4 FAB variants) and 43 adults (26 with M2 and 17 with M4 FAB variants) given therapy of standard intensity in the regimen 3+7 and 2+5.

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The paper discusses what immunomorphology is, which place it occupies in immunology today after methods of molecular biology, gene engineering, biotechnology have been intensively used in research, what basic methods and approaches are applied to immunological studies. Data available in the literature on the development, establishment, and prospects of immunomorphology and some morphofunctional evidences obtained by the Laboratory of Immunomorphology, Institute of Clinical and Experimental Morphology. Siberian Branch of the Russian Academy of Medical Sciences, from the physiological and morphocytochemical studies of the lymphoid system in health and in disease with circadian variations in mind.

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