WordNet

of critical importance and consequence; "an acute (or critical) lack of research funds"
having or demonstrating ability to recognize or draw fine distinctions; "an acute observer of politics and politicians"; "incisive comments"; "icy knifelike reasoning"; "as sharp and incisive as the stroke of a fang"; "penetrating insight"; "frequent penetrative observations" (同)discriminating, incisive, keen, knifelike, penetrating, penetrative, piercing, sharp
extremely sharp or intense; "acute pain"; "felt acute annoyance"; "intense itching and burning" (同)intense
having or experiencing a rapid onset and short but severe course; "acute appendicitis"; "the acute phase of the illness"; "acute patients"
of an angle; less than 90 degrees
malignant neoplasm of blood-forming tissues; characterized by abnormal proliferation of leukocytes; one of the four major types of cancer (同)leukaemia, leucaemia, cancer of the blood
a large immature monocyte normally found in bone marrow

PrepTutorEJDIC

(先の)『鋭い』,とがった / (痛み・感情などが)『激しい』,強い / (知力・感覚などが)『鋭い』,鋭敏な / (事態が)重大な / (病気が)急性の / (音が)高い,鋭い / 鋭角の
白血病

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/08/10 10:39:21」(JST)

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Acute monocytic leukemia (AMoL, or AML-M5)^[1] is considered a type of acute myeloid leukemia.

Diagnosis[edit source | edit]

In order to fulfill World Health Organization (WHO) criteria for AML-5, a patient must have greater than 20% blasts in the bone marrow, and of these, greater than 80% must be of the monocytic lineage. A further subclassification (M5a versus M5b) is made depending on whether the monocytic cells are predominantly monoblasts (>80%) (acute monoblastic leukemia) or a mixture of monoblasts and promonocytes (<80% blasts). Monoblasts can be distinguished by having a roughly circular nucleus, delicate lacy chromatin, and abundant, often basophilic cytoplasm. These cells may also have pseudopods. By contrast, promonocytes have a more convoluted nucleus, and their cytoplasm may contain metachromatic granules. Monoblasts are typically MPO-negative and promonocytes are MPO variable. Both monoblasts and promonocytes stain positive for non-specific esterase (NSE), however NSE may often be negative.

Immunophenotypically, M5-AML variably express myeloid (CD13, CD33) and monocytic (CD11b, CD11c) markers. Cells may aberrantly express B-cell marker CD20 and the NK marker CD56. Monoblasts may be positive for CD34.

Causes[edit source | edit]

M5 is associated with characteristic chromosomal abnormalities, often involving Chromosome 11 at 11q23 or t(9;11) affecting the MLL locus, however the MLL translocation is also found in other AML subtypes. MLL is believed to be prognostically unfavorable in AML-M5 compared to other genetic alterations involving MLL such as t(9;11). The t(8;16) translocation in MLL is associated with hemophagocytosis.

Secondary leukaemia, which may include AML-M5, has been associated with exposure to epipodophyllotoxins, such as etoposide.^[2]

Treatment[edit source | edit]

AML-M5 is treated with intensive chemotherapy (such as anthracyclines) or with bone marrow transplantation.

References[edit source | edit]

^ "Acute Myeloid Leukemia - Signs and Symptoms".
^ Kollmannsberger, C.; et al. (Oct 1998). "Secondary leukemia following high cumulative doses of etoposide in patients treated for advanced germ cell tumors.". J. Clin. Oncol. (16(10)): 3386–91.

External links[edit source | edit]

Images at Nagoya University
Image at hmds.org.uk
Histology at University of Virginia
Overview at Marist College

UpToDate Contents

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1. 急性骨髄性白血病の分類 classification of acute myeloid leukemia
2. 急性骨髄性白血病の臨床症状、病理学的特徴、および診断 clinical manifestations pathologic features and diagnosis of acute myeloid leukemia
3. 高齢者における急性骨髄性白血病の治療 treatment of acute myeloid leukemia in older adults
4. 若年成人における急性骨髄性白血病に対する導入療法 induction therapy for acute myeloid leukemia in younger adults
5. 骨髄穿刺塗抹標本の評価 evaluation of bone marrow aspirate smears

English Journal

Oncoprotein Cot1 represses kinase suppressors of Ras1/2 and 1,25-dihydroxyvitamin D3-induced differentiation of human acute myeloid leukemia cells.

Wang X, Studzinski GP.SourceDepartment of Pathology and Laboratory Medicine, UMDNJ-New Jersey Medical School, Newark, New Jersey 07101-1709, USA.
Journal of cellular physiology.2011 May;226(5):1232-40. doi: 10.1002/jcp.22449.
Metabolites and derivatives of vitamin D are well-known inducers of monocytic differentiation, but the mechanistic basis for their action is not fully elucidated. Here we show that the product of protooncogene Cot1 represses the monocytic phenotype in human acute myeloid leukemia (AML) cells induced
PMID 20945381

Ubiquitination is associated with lysosomal degradation of cell surface-resident ABCA1 through the ESCRT pathway.

Mizuno T, Hayashi H, Naoi S, Sugiyama Y.SourceLaboratory of Molecular Pharmacokinetics, Graduate School of Pharmaceutical Sciences, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
Hepatology (Baltimore, Md.).2011 Apr 21. doi: 10.1002/hep.24387. [Epub ahead of print]
ATP-binding cassette transporter A1 (ABCA1) plays an essential role in the biogenesis of high-density lipoprotein in liver and in the prevention of foam cell formation in macrophages by mediating the efflux of cellular cholesterol and phospholipids to apolipoprotein A-I (apoA-I). Our current study i
PMID 21520210