clinical case

From: J.Paul Robinson (robinson@flowcyt.cyto.purdue.edu)
Date: Fri May 16 1997 - 15:34:15 EST


This message is posted on behalf of Dr. Rafael Nunez: Please reply directly:
----------------------------------------------------------------
>Dear Dr. Porwitt-MacDonald:
>Thank you very much for let us know about your interesting case.
>Before that, we will like to ask: 1. At which clinical level the
>patient had mediastinal mass or skin nodules? At their clinical
>initial presentation or during the relapse? 2. It was checked the
>expression of
>CD38 on the cell surface of the Blasts? 3. Which were the karyotypic
>results  in both situations?
>The case that you present could be categorized (retrospectively)  from the
>beginning as a Bi-phenotipic leukemia, based in T-cell expression antigens
>with
>T-cell receptor rearrangements plus expression of CD33, CD13, CD34.
>In fact, at the relapse the common antigens that are expressed are:
>TdT, CD7. CD34, CD33, CD13. However, the T cell diagnosis looked
>the appropiate at diagnosis time.
>I hope so that this information can be useful:
>1.- In: Schmidt CA et als: Leuk Lymph, 1999,20:45-49: they present
>several cases of the expression of TCR delta rearrangements
>associated to T-antigens in AML, without a critical significance for
>the TdT expression.
>2.- However in: Farahat N et al: (Catovsky's  team): Leukemia:
>1995;9:583-7. The present that is not as critical the expression of
>TdT but their intensity determined by flow cytometry that allow a
>clear cut difference between B,T or AML.
>3.- Oez S et al, in: Ann Hematol: 1996: 72:307-16. Present a cell
>line derived from a patient with AML wich express a clear T cell
>phenotype with expression of CD34 and acquisition of CD33, but spite
>of different phenotypic variability in culture, it was not possible
>to separate a subclone because the cells regain the same phenotypic
>appearance with the time.
>4.- Another 2 examples of bi-phenotypic T/Myeloid leukemias:
>a.- Launder TM et als: Am J Clin Path: 1996:106:185-91 and
>b.- Carbonell F et als. (Catovsky's team): Leukemia: 1996:10:1283-7
>Finally. It looks like this patient will have to receive Bone Marrow
>transplant for the actual AML.
>Please, let us know any comment that you have regarding the patient
>outcome.
>Sincerely:
>Cesar Nunez, MD.
>University of Manchester
>School of Biological Sciences
>G.38 Stopford Building
>Oxford Road
>Manchester M13 9PT
>England
>Rafael Nunez MD. MSc. Assist. Prof.
>Institute of Virology, University of Zürich
>Switzerland
>rafaeln@vetvir.unizh.ch
>cnunez@fs1.scg.man.ac.uk
>
>                                     \|/
>                                    (o o)
>________________________________oOo__(_)__oOo______________________________
___
>    ___/\_    | Rafael Nunez                  mailto:rafaeln@vetvir.unizh.ch
>   /    o \/| | University Inst.for Virology  http://www.unizh.ch/vetvir
>  /        _| | Winterthurerstr. 266a         Telephone: (+41) 1 6358709
> /_/\__/-\/   | 8057 Zurich SWITZERLAND       Faximile : (+41) 1 6358911
>___________________________________________________________________________
___




Posted for the above by:

__________________________________________________________________
J.Paul Robinson, Ph.D., Professor of Immunopharmacology
Director, Purdue University Cytometry Laboratories
Purdue University	Phone:(765)-4940757   FAX: (765)-4040517
EMAIL: robinson@flowcyt.cyto.purdue.edu WEB: http://www.cyto.purdue.edu



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