clinical case

J.Paul Robinson (robinson@flowcyt.cyto.purdue.edu)
Fri, 16 May 1997 15:34:15

This message is posted on behalf of Dr. Rafael Nunez: Please reply directly:
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>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 Z=FCrich
>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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CD-ROM Vol 3 was produced by Monica M. Shively and other staff at the Purdue University Cytometry Laboratories and distributed free of charge as an educational service to the cytometry community. If you have any comments please direct them to Dr. J. Paul Robinson, Professor & Director, PUCL, Purdue University, West Lafayette, IN 47907. Phone: (765)-494-0757; FAX(765) 494-0517; Web http://www.cyto.purdue.edu , EMAIL cdrom3@flowcyt.cyto.purdue.edu