Zur Typenverteilung, Alters- und Geschlechtsdisposition der akuten Leukämien des Erwachsenen

Atypical (Monomyelocytic) Myelogenous Leukemia

“…The index of the alkaline phosphatase in the mature granulocytes varied in each of the different patients and, allowing for the small num ber of cases studied, no precise statement can be made concerning this aspect. No alkaline phosphatase was detected in the leukemic monocytoid cells [1,36,38]. The results of the tests for the naphthylamidase presence varied from a low to a marked positive reaction in the smears tested.…”

“…Leukemic myeloblasts or paramyeloblasts stain only weakly with Sudan black B and exhibit a faintly traceable peroxidase activity [1,19,53]. Chloracylesterase can only exceptionally be detected in these cells [1,53], The latter enzyme reaction stains markedly or strongly the cytoplasm of promyelocytes and myelocytes which also contain very conspicuous peroxidase activity and abundant sudanophilia with Sudan black B [1,19,35,53]. Leukemic as well as normal promyelocytes show varying degrees of N-AS-esterase activity which, unlike that in monocytes, may be slightly or not at all inhibited by NaF [1,20,48,53] (fig.…”

The Application of Cytochemical Methods to the Study of Acute Leukemia

“…Myeloma cells and leukemic plasma cells may be identified by the charac teristically greater activities of both their paranuclear acid phosphatase and their a-naphthyl-acetate esterase [1,33,42].…”

“…For instance, in acute erythremias and erythroleukemias the leukemic erythroblasts exhibit very strong esterase splitting a-naphthyl-acetate for most part exceeding the enzyme activity observed in normal or otherwise pathological erythroblasts. Further traits frequently encountered in leukemic erythroblasts include an increase in the normal acid phosphatase activity in a circumscribed paranuclear area, as well as increased iron content and marked PAS-positivity in the leukemic erythroblasts [1,13,28,32].…”

“…The criteria that have proven to be most useful in diagnosing monocytic leukemia when ex- Table I hibited as follows are: The presence of marked amounts of sodium fluoride (NaF) -and organophosphate -sensitive esterase splitting naphthol-ASacetates accompanied by relatively faint positive staining reactions with Sudanblack-B and for peroxidase as well as for chloracylesterase [1,47], In fact, all the cases identified by these means as monocytic leukemia behaved accordingly in the further fairly specific tests: (1) they showed an early and abnormally rapid monocyte emigration in skin window experiments [45] with consecutive transformation into macrophages [45]; (2) when cultured in vitro, the leukemic cells transformed depending upon to the culture technique into large vacuolated macrophages or fibroblast-like cells [38,39,50]; (3) in all cases showing predominantly mature cells the serum and urinary lysozyme levels were very high [4,9,40,41]; (4) in the few cases tested, the leukemic cells showed an IgG-receptor activity [9] reported to be specific for the mono cytes and macrophages [22], The 4 criteria listed above plus the cytochemical pattern previously cited provide the most reliable methods for establishing the diagnosis of monocytic leukemia [9]. We had the occasion to study some cases which, according to other authors [27,29,32], should be identified as monocytic leukemia but in our tests failed to show either the typical NaF-sensitive naphthol-AS-acetateesterase as well as the characteristic lysozyme levels or the behaviour typically observed in the skin window experiments oi in the in vitro cultivation.…”