ABNORMALITIES IN GRANULE FORMATION IN ACUTE MYELOGENOUS LEUKEMIA

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  • 1 January 1977
    • journal article
    • research article
    • Vol. 49  (5) , 693-704
Abstract
Granule formation was investigated in differentiating neutrophils of a patient with acute myelogenous leukemia (AML) by EM and peroxidase cytochemistry. Two important pathologic features were observed: an abnormal concentration and packaging of peroxidase into Auer rods in leukemic promyelocytes, and the presence of Auer rods surrounded by single unit membranes in some mature polymorphonuclear leukocytes (PMN). An additional unexpected finding was the discovery of 2 distinct populations of PMN circulating concurrently; a minor (< 5%) normal one that contained peroxidase positive azurophilic and peroxidase negative specific granules and a major abnormal one characterized by the absence of specific granules. None of these abnormalities was observed during the 2 remissions of this patient''s disease. During relapse a hiatus leukemicus occurred, which also revealed 2 populations of cells, a majority population of leukemic blasts, and a minority population of a few normal PMN. These findings documented several developmental abnormalities in the differentiating cells of myelogenous leukemia and also suggested that concurrent normal and abnormal populations of PMN may be a helpful diagnostic feature of a leukemic process.