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KMID : 0350519950480010291
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Journal of Catholic Medical College
1995 Volume.48 No. 1 p.291 ~ p.299
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Changes of Morphology and Ratio of T and B Cells of Spleen in Chronic Myelogenous Leukemia
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Abstract
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Chronic myelogenous leukemia(CML) is one of a group of hematologic disorders characterized by a proliferative abnormality in the stem cell common to myeloid, erythroid, megakaryocytic, and perhaps fibroblastic precursors of the bone marrow. It
has
been
known that the spleen shows prominent extramedullary hematopoiesis and splenomegaly is present at the time of diagnosis in more than 90% of CML. However, only a few studies about the morphological changes and alteration of T, B cell ratio of
spleen
in
CML have been reported. And the morphological difference of the spleen between chronic phase and blastic crisis and the relationship between survival and morphologic changes are unknown. In order to evaluate the morphological difference of the
spleen
between chronic phase and blastic crisis, and to know the relationship between survival and morphology, and ratio of spleen, we investigated morphology, ratio of T/B cells of the spleen, and degree of bone marrow fibrosis in 40 patients with
CML(31
chroic phase, 9 blastic crisis) and 8 control group using hematoxylin-eosin, reticulin, Masson-trichrome, and immunohistochemical stain.
@ES The results were as follows ;
@EN 1. The changes of splenic morphology in CML were white pulp obliteration(97.5%), splenic fibrosis(85.0%), and the infiltration of eosinophil(85.0%), granulocytic precurosers(100%), splenic fibrosis(85.0%) and the infiltration of
eosinophil(85.0%),
granulocytic preeurosors(100%), erythroid precursors(92.5%), and megakaryocytes(55.0%).
2. The infiltration of megakaryocytes in the spleen was significantly increased in blastic crisis than chronic phase.
3. There was no significant relation between bone marrow fibrosis and splenic weight, fibrosis, and extramedullary hematopoiesis.
4. The ratio of T/B cells of spleen was (1.94 : 1) and blastic crisis(1.96 : 1).
5. The patients showing higher grade of extramedullary granulopoiesis revealed longer survival time.
Above results indicate that the morphology and ratio of T/B cells of spleen in CML are changed, especially, the infiltration of megakaryocytes of spleen is different between chronic phase and blastic crisis of CML. However, the lymphocyte subsets
are
not changed. And the extramedullary granulopoiesis and megakarypoiesis are important factors to predict survival time or clinical phase.
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KEYWORD
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