肿瘤细胞治疗研究
英文原题：Implications of an unusual acute leukaemia phenotype on the care of a South African Jehovah's Witness patient.
涂片复核显示，原始细胞占66%，未见能辨别细胞系列的形态学特征。
一名50多岁的HIV阴性南非女性因乏力就诊于医院。她既往无病史，是耶和华见证人。她的全血细胞计数显示大细胞性贫血和重度血小板减少。涂片复核显示66%的原始细胞，无明显区分系的形态学特征。外周血流式细胞术显示原始细胞群体表达B细胞标志（CD19弱阳性、cCD79a弱阳性、CD10弱阳性、CD22中等阳性）、T/NK细胞标志（CD7）和髓系标志（HLA-DR、CD33、CD117）。然而，抗原组合未满足特定系别归属的要求。骨髓穿刺和环钻活检显示细胞增生极度活跃，原始细胞弥漫性浸润。随后通过细胞化学和免疫组织化学确认髓过氧化物酶阳性。最终诊断为急性髓系白血病，伴异常淋系标志物表达和单核细胞化学特征。系别归属的延迟可能妨碍及时诱导治疗、动摇患者信心并推迟医患治疗讨论。这在本身已处于弱势的人群中尤为重要。
An HIV-negative South African woman in her 50s presented to hospital with fatigue. She had no medical history and is a Jehovah's Witness. Her full blood count revealed macrocytic anaemia and severe thrombocytopenia. On smear review, there were 66% blasts with no lineage discerning morphological features. Peripheral blood flow cytometry revealed a blast population that expressed B-cell (CD19 dim, cCD79a dim, CD10 dim, CD22 moderate), T/NK-cell (CD7) and myeloid markers (HLA-DR, CD33, CD117). However, antigen combinations did not fulfil the requirements for specific lineage assignment. The bone marrow aspirate and trephine biopsy were hypercellular with diffuse involvement of blasts. Myeloperoxidase positivity was subsequently confirmed on cytochemistry and immunohistochemistry. The final diagnosis was an acute myeloid leukaemia with expression of aberrant lymphoid markers and monocytic cytochemistry. Delays in lineage assignment can derail timely induction, shake patient confidence and postpone the doctor-patient treatment discussions. This is particularly important in already vulnerable populations.
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