ISSN 2415-3060 (print), ISSN 2522-4972 (online)
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JMBS 2020, 5(1): 172–178
https://doi.org/10.26693/jmbs05.01.172
Clinical Medicine

Acute Monocitary Leukosis

Pesotskaya L. 1, Getman M. 1, Simonova T. 1, Pisarevskaya O. 1, Opriatnaya T. 2
Abstract

Acute myeloid leukemia is a clonal tumor disease of the hematopoietic tissue associated with a mutation in the hematopoietic progenitor cell, which results in differentiation block and uncontrolled proliferation of immature myeloid cells. Material and methods. We used clinical data, morphological, cytochemical, cytogenetic, immunophenotypic blood and bone marrow studies. Results and discussion. Monocytic leukemia can be subdivided into acute monocytic leukemia, acute myelomonocytic leukemia, and chronic myelomonocytic leukemia. Monocytic acute leukemia accounts for about 3-6% of all acute myeloid leukemias. The average age of patients is about 50 years, but this disease can occur at different ages. Acute monoblastic leukemia is most common in young people, and monocytic usually happens to adults. Acute monocytic leukemia differs from all acute myeloid leukemias to which it belongs, according to ICD 10, by spreading to the tissues without corresponding significant acute complaints of patients, which frequently causes their late visit to the doctor. However, morphological changes in the analysis of peripheral blood may not yet be pronounced, which also complicates the diagnosis for clinicians, especially in the context of limiting the necessary highly qualified studies. Therefore, reviews of particular types of acute myeloid leukemia for timely suspecting of the disease and consultation of the hematologist are relevant. Patients' complaints and clinical signs of acute monocytic leukemia are similar to those of acute myelomonocytic leukemia and are manifestations of bone marrow failure. In particular, anemic, hemorrhagic syndrome in the form of bruising on the skin and bleeding from the mucous membranes, fever, general intoxication, infectious complications that are poorly treatable are characteristic. Typical for the clinic of monocytic leukemia is the development of a tumor from leukemic cells outside the bone marrow (myelosarcoma, chromium), lesions of the skin with widespread rash, gum hypertrophy with bleeding. In addition to clinical, there are certain histological, immunohistochemical, cytochemical, phenotypic and cytogenetic differential diagnostic features of monocytic leukemias, and prognostic factors of their course, other than myeloblastic leukemias. Conclusion. The clinical picture of the course of acute monocytic leukemia differs from other types of acute myeloid leukemia by frequent lesions of tissues outside the organs of hematopoiesis: skin with rashes, gingival hyperplasia with bleeding, which was observed in the presentation of the clinical case. The morphological features of monocytic germ cells are partially differentiated or mature, with a negative response to myeloperoxidase in them, in contrast to acute myeloblastic leukemias. The presence of monocytosis in peripheral blood with signs of cell rejuvenation, even in the absence of blast cells, requires timely cytological examination of the bone marrow to exclude acute monocytic leukemia. It is necessary to further accumulate world experience of clinical cases observation and modern methods of acute monocytic leukemia diagnosis for its timely diagnosis.

Keywords: acute monocytic leukemia, diagnosis, course

Full text: PDF (Ukr) 2.11M

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