Biomedical subjects

A Robert

Publications and source records attributed to A Robert.

At least 91 records · Page 5Linked to original sources

PubMed1999

Respiratory function in children undergoing bone marrow transplantation.

We conducted a prospective study of respiratory function in children undergoing bone marrow transplantation (BMT) for onco-hematological disorders. Each child was evaluated before and 100 days after BMT. The investigations included clinical examination, chest X-ray, and pulmonary function tests (PFT) to determine: slow vital capacity (VC), functional residual capacity (FRC), total lung capacity (TLC), forced expiratory volume in 1 s (FEV1), carbon monoxide diffusing capacity (DLCO), ratio of residual volume (RV) to TLC, and FEV1/VC. The values obtained before and after BMT were compared to predicted values, and the post-BMT values were compared to the pre-BMT values (Student's t-test). From 1986 to 1995, 77 children underwent BMT, of whom 39 were available for testing. The pre-BMT VC (P = 0.0234) and DLCO (P < 0.0001) were lower and FRC higher (P < 0.0001) than predicted values. After BMT, the VC (P = 0.004), TLC (P = 0.044), and FEV1 (P = 0.012) were lower, and the RV/TLC ratio was higher (P = 0.043), compared with pre-BMT data. The observed respiratory abnormalities were not clinically relevant. The only identifiable risk factor for a decrease in lung function was age at BMT. This study shows that some lung dysfunction may be present before BMT and be further altered by BMT. This stresses the need for longitudinal respiratory monitoring and follow up to detect such dysfunctions and to insure an optimal treatment program for these children.

Age Factors↗

PubMed1999

Biological monitoring of workers exposed to 4,4'-methylene-bis-(2-orthochloroaniline) (MOCA). I. A new and easy determination of "free" and "total" MOCA in urine.

OBJECTIVE: The objective of the study was to validate a new and simple method to determine MOCA in the urine of exposed workers. METHODS: The separation, identification and quantification of urinary MOCA were performed in spiked urines by a sensitive and practical high-performance liquid chromatography (HPLC) method and applied to urine samples of 11 workers occupationally exposed to MOCA; the postshift urinary levels of MOCA in their urine samples with and without hydrolysis, "total" and "free" MOCA respectively, were determined. In addition, we investigated the use of citric or sulfamic acid as preservatives of urine samples. RESULTS: The "total" and "free" MOCA were extracted with isooctane from hydrolysed and nonhydrolysed 20-ml urine samples respectively. After evaporation, the residue was dissolved in 4 ml of 2.10(-2) M aqueous hydrochloric acid and analysed by an isocratic HPLC system using both ultraviolet (UV) detection at 244 nm and electrochemical detection working in oxidation mode (0.9 V) with an Ag/AgCl reference electrode. Mobile phase (50% acetonitrile in water containing 0.4% acetate buffer solution pH = 4.6) was used to complete the 20-min analysis. "Free" and "total" MOCA were chromatographed on a reversed-phase C8 column (5 microns, 250 mm x 4 mm). The standard curve of MOCA was linear over the range 5-500 micrograms/l in human urine. The detection limit was 1 microgram/l for a 20-microliter injection volume; the repeatability ranged from 5.6 to 1.3% (n = 6) for spiked urines at 5 and 500 micrograms/l, with a percentage recovery of 94 +/- 3%. The reproducibility of the method was 7.3% (n = 4) for spiked urine at 10 micrograms/l. The use of sulfamic acid as a preservative of urine samples is important to improve the precision and accuracy of the analysis. CONCLUSION: The results indicate that these analytical procedures using conventional apparatus may be used routinely and reliably with large numbers of urine samples for biological monitoring of the exposure to MOCA. The occupational exposure to MOCA in some factories in France is studied in the second part of this work.

Carcinogens↗

PubMed1999

Biological monitoring of workers exposed to 4,4'-methylene-bis-(2-orthochloroaniline) (MOCA). II. Comparative interest of "free" and "total" MOCA in the urine of exposed workers.

OBJECTIVES: The objectives of the study were to investigate the best urinary marker of exposure to MOCA in urine samples of exposed workers and to study its applicability in exposure evaluation in polyurethane resin production plants. In addition, our intention was to contribute to the question of biological target value in order to reduce exposure levels. METHODS: Urinary MOCA markers were measured in urine samples collected at the end of the workshifts. 40 workers from four factories were observed for three consecutive days in the same week. "Free" MOCA in non-acid-stabilized urines, "total" MOCA in urines after alkaline hydrolysis, "acid-labile" MOCA in sulfamic or citric acid-protected urines were measured in all urine samples. MOCA liberated by heating the non-acid-stabilized urines ("heat-labile" MOCA) was also measured in 17 urine samples of exposed workers. RESULTS: The median value of "free" MOCA was lower than that of "sulfamic acid-labile" MOCA: 6.0 and 12.5 micrograms/l respectively. The difference between "free" and "total" MOCA was statistically significant (Mann-Whitney test, P = 0.023) for the urine samples collected without acid. Correlations between urinary MOCA concentrations in hydrolysed and non-hydrolysed urine samples were high (r = 0.984, 0.966 and 0.950; P < 0.001) for urine samples with sulfamic acid, with citric acid and without acid respectively. For all the factories, the postshift urinary MOCA concentrations ranged between 1 microgram/l (detection limit) and 570 micrograms/l; 25% of "sulfamic acid-labile" MOCA concentrations exceeded 50 micrograms/l. Workers handling crystallized MOCA excreted the highest amounts of MOCA in urine. The urinary MOCA concentrations (median) were: 84.0 micrograms/l (mixer), 15.5 micrograms/l (moulder). 59.0 micrograms/l (maintenance) and 3.0 micrograms/l (others). CONCLUSIONS: MOCA measured in sulfamic acid-protected urine samples without hydrolysis provides a more practical and reliable biomarker than "total" MOCA (after hydrolysis) or "free" MOCA. A biological guiding value of 20 micrograms/l expressed as "sulfamic acid-labile" MOCA is proposed.

Chemical Industry↗

PubMed1999

Human atrial repolarization: effects of sinus rate, pacing and drugs on the surface electrocardiogram.

OBJECTIVES: We studied the effects of rate and some cardioactive drugs on the atrial surface electrocardiogram (ECG). BACKGROUND: In atrioventricular block, atrial surface ECG is unmasked. The effect of rate alone permits detection of the effect of other exogenous stimulations such as drugs in the presence of rate alterations. METHODS: High fidelity, high gain ECG leads I, II and III were recorded from 51 patients with heart block. Durations of P and Ta waves and the total PTa interval were measured from nonconducted atrial events. RESULTS: No relationship was found between sinus cycle length and PTa, P or Ta in 31 patients. In 20 patients, progressively decreasing the atrial pacing cycle length from 853 ms to 381 ms resulted in a linear reduction of the PTa interval from 444 to 291 ms (rho = 0.76, slope = 0.24). This was largely due to shortening of Ta. A linear rate correction formula was derived: corrected PTa = PTa - 0.24 (PP - 1000). Atropine (0.02 mg/kg) shortened the PP interval (p < 0.001) and the PTa interval (p < 0.01). Propranolol (0.1 mg/kg) prolonged the PP interval (p < 0.001) but did not alter the PTa interval. Neither disopyramide (2.0 mg/kg) nor flecainide acetate (2.0 mg/kg) altered the PP interval, but both prolonged the PTa interval (p < 0.001). This was largely due to P wave lengthening after flecainide (p < 0.001) and to Ta prolongation after disopyramide (p < 0.001). CONCLUSIONS: In heart block, PTa, P and Ta waves can be measured reliably. The effects of pacing and some antiarrhythmic drugs on the atrial myocardium are similar to those known at the ventricular level.

Adult↗

PubMed1999

An in vitro selected binding protein (affibody) shows conformation-dependent recognition of the respiratory syncytial virus (RSV) G protein.

Using phage-display technology, a novel binding protein (Z-affibody) showing selective binding to the RSV (Long strain) G protein was selected from a combinatorial library of a small alpha-helical protein domain (Z), derived from staphylococcal protein A (SPA). Biopanning of the Z-library against a recombinant fusion protein comprising amino acids 130-230 of the G protein from RSV-subgroup A, resulted in the selection of a Z-affibody (Z(RSV1)) which showed G protein specific binding. Using biosensor technology, the affinity (K(D)) between Z(RSV1) and the recombinant protein was determined to be in the micromolar range (10(-6) M). Interestingly, the Z(RSV1) affibody was demonstrated to also recognize the partially (54%) homologous G protein of RSV subgroup B with similar affinity. Using different recombinant RSV G protein derived fragments, the binding was found to be dependent on the presence of the cysteinyl residues proposed to be involved in the formation of an intramolecular disulfide-constrained loop structure, indicating a conformation-dependent binding. Results from epitope mapping studies, employing a panel of monoclonal antibodies directed to different RSV G protein subfragments, suggest that the Z(RSV1) affibody binding site is located within the region of amino acids 164-186 of the G protein. This region contains a 13 amino acid residue sequence which is totally conserved between subgroups A and B of RSV and extends into the cystein loop region (amino acids 173-186). The potential use of the RSV G protein-specific Z(RSV1) affibody in diagnostic and therapeutic applications is discussed.

Amino Acid Sequence↗

PubMed1999

Dystrophin and utrophin complexed with different associated proteins in cardiac Purkinje fibres.

Abnormal dystrophin expression is directly responsible for Duchenne and Becker muscular dystrophies. In skeletal muscle, dystrophin provides a link between the actin network and the extracellular matrix via the dystrophin-associated protein complex. In mature skeletal muscle, utrophin is a dystrophin-related protein localized mainly at the neuromuscular junction, with the same properties as dystrophin in terms of linking the protein complex. Utrophin could potentially overcome the absence of dystrophin in dystrophic skeletal muscles. In cardiac muscle, dystrophin and utrophin were both found to be present with a distinct subcellular distribution in Purkinje fibres, i.e. utrophin was limited to the cytoplasm, while dystrophin was located in the cytoplasmic membrane. In this study, we used this particular characteristic of cardiac Purkinje fibres and demonstrated that associated proteins of dystrophin and utrophin are different in this structure. We conclude, contrary to skeletal muscle, dystrophin-associated proteins do not form a complex in Purkinje fibres. In addition, we have indirect evidence of the presence of two different 400 kDa dystrophins in Purkinje fibres.

Animals↗

PubMed1999

Presence of invertebrate dystrophin-like products in obliquely striated muscle of the leech, Pontobdella muricata (Annelida, Hirudinea).

Dystrophin is a 427-kDa cytoskeletal protein, which occurs in scant amounts in vertebrate muscle and nerve cells. No previous references to dystrophin or associated proteins in invertebrates at the protein level have been found, while two recent studies investigated the presence of genes encoding proteins homologous to dystrophin in sea urchin and other invertebrates such as Drosophila melanogaster. In this study, the possible presence and distribution of dystrophin-like proteins were studied in different invertebrate muscle cell types and species through Western blot analysis and light and electron microscope immunohistochemistry using a panel of antibodies whose specificities have been determined in vertebrates. Crude protein extracts of leech Pontobdella muricata were analysed by Western blotting. The revealed protein band, with 140 kDa molecular weight, was related to dystrophin, utrophin or dystrophin-related protein-2 (DRP2) according to the specificities of the antibodies used to detect them. The immunofluorescence study showed positive immunoreactions in obliquely striated muscle of this hyrudinean. The immunoelectron microscopy study confirmed specific immunogold labelling beneath the sarcolemma of muscle cells. We thus assume that this protein is an invertebrate dystrophin-like product that is referred to as IDLp140. The potential functions of this invertebrate dystrophin-like protein in invertebrate muscles are discussed relative to previous data in vertebrate tissues.

Animals↗

PubMed1999

Utrophin and dystrophin-associated glycoproteins in normal and dystrophin deficient cardiac muscle.

In this study, various members of the dystrophin family (dystrophin, the short dystrophin product Dp 71, utrophin and DRP2), and different members of the dystrophin-associated glycoprotein (DAG) complex (beta-dystroglycan, alpha-, beta-, gamma- and delta-sarcoglycans) were localized in bovine cardiac muscle using a battery of specific antibodies. We have established that dystrophin is exclusively associated with beta-dystroglycan and both alpha- and delta-sarcoglycans in cardiac muscle cell membranes. In contrast, utrophin is a specific component of intercalated disks together with beta- and gamma-sarcoglycans, while beta-dystroglycan, alpha- and delta-sarcoglycans are not present. Dp 71 is mainly localized at the T tubule transverse area. In dystrophin deficient cardiac muscle, utrophin and beta-sarcoglycan were observed in intercalated disks and at the sarcolemma of each cardiocyte. Our results revealed that complexes of associated glycoproteins differ in cardiac muscle when associated with dystrophin or utrophin. Despite the described sequence homologies between dystrophin and utrophin, the present results indicate that these proteins have different roles in some specific cardiac cell areas.

Amino Acid Sequence↗

PubMed1999

Leukaemic presentation of small cell variant anaplastic large cell lymphoma: report of four cases.

We report four cases of a rare subtype of CD30-positive anaplastic large cell lymphoma (ALCL) with a predominant small cell component (small cell variant of ALCL) presenting with a leukaemic feature. Lymph node biopsy showed malignant cells of varying size with a predominant population of small to medium-sized malignant cells associated with large anaplastic cells strongly positive for CD30 and epithelial membrane antigen (EMA). Both large and small cells were reactive with antibody ALK1, which recognizes the chimaeric NPM-ALK protein associated with the t(2;5)(p23;q35). All patients presented with hyperleucocytosis with atypical small lymphocytes. Bone marrow involvement was detected on both aspirate and bone marrow trephine where scattered malignant cells were only demonstrated by immunostaining for CD30 and ALK protein. Atypical cells in peripheral blood, lymph node and skin biopsies showed a T or null cell phenotype. Cytogenetic analysis of blood, bone marrow and/or lymph node revealed the t(2:5)(p23;q35) characteristic of ALCL. The patients responded to chemotherapy but showed early relapse without abnormal cells in peripheral blood. This report shows that the small cell variant of ALCL may have a leukaemic presentation with peripheral blood involvement by atypical lymphocytes and provides evidence that, in the small cell variant of ALCL, the small cell component is a part of the malignant clone.

Adolescent↗

PubMed1999

Influence of hemodialysis membrane type on pentosidine plasma level, a marker of "carbonyl stress".

UNLABELLED: Influence of hemodialysis membrane type on pentosidine plasma level, a marker of "carbonyl stress." BACKGROUND: The accumulation of advanced glycation end products (AGEs) in uremia has been ascribed to the retention of carbonyl precursors of AGEs. Pentosidine plasma level has been identified as a surrogate marker of carbonyl precursors ("carbonyl stress"). The influence of hemodialysis (HD) membrane type and residual diuresis on carbonyl stress has not been studied. METHODS: We measured protein-linked and free plasma pentosidine (a surrogate marker of carbonyl stress) by high-performance liquid chromatography in patients on HD with low-flux cellulose (N = 29), high-flux polysulfone (PS; N = 57), polymethylmethacrylate (PMMA) (N = 25), and AN69 (N = 15). RESULTS: Both protein-linked and free pentosidine were similar on low-flux cellulose, high-flux PMMA, and AN69, but were lower (P < 0.01) on high-flux PS. Pentosidine levels were virtually identical on Fresenius and Asahi PS in Japanese and Belgian patients. By multivariate analysis, only the type of HD membrane and residual diuresis proved to be independent determinants (P < 0.001) of pentosidine levels. During a single HD session, the clearance of free pentosidine was similar with all membranes. In three patients who were switched from AN69 to PS, the protein-linked pentosidine level dropped to the control level after resumption of the AN69 membrane. CONCLUSIONS: Both HD membrane type and residual diuresis are independent determinants of pentosidine plasma level, which is a marker of carbonyl stress.

Aged↗

PubMed1999

Screening for identified and unidentified protein C pathway defects by the Agkistrodon contortrix venom test in consecutive patients.

To determine the real performance of the Agkistrodon contortrix venom (ACV) screening test for protein C (PC) pathway defects, we studied 400 consecutive patients referred for the study of personal venous thrombosis or for family study. All 82 patients with factor V Arg 506 Gln (FV R506Q) (n = 82), 6 patients with activated PC resistance without FV R506Q, 17 patients with PC deficiencies, and 9 patients with combined defects were identified by an abnormal ACV result. Three of 6 protein S deficiencies overlapped the normal range. Among the 280 patients without a PC pathway defect, 63 of 193 with thrombosis and 18 of 87 asymptomatic subjects (relatives of patients with thrombosis) had an abnormal ACV result. A significant linear inverse relationship was observed between the ACV results and factor VIII. However, 31 of 63 patients (49%) with thrombosis and 15 of 18 (83%) asymptomatic subjects with an abnormal ACV had a normal factor VIII level. This test, with a 100% negative predictive value, is reliable for screening for PC deficiencies and for FV R506Q and can be used safely as an exclusion test. Moreover, the test may be useful to indicate, in the PC pathway, unidentified risk factors for venous thrombosis.

Adolescent↗

PubMed1999

Habitual abortions in 678 healthy patients: investigation and prevention.

The objective of this study of patients with habitual abortion (HA), was to determine their autoimmune profile and to try to prevent new abortions using low-dose aspirin for 7 months with prednisone in the first trimester only, or with low-dose aspirin alone. A total of 678 healthy patients with three or more HA were investigated for antiphospholipid antibodies, antinuclear and antithyroid antibodies. Among these patients, 277 pregnant women were treated, 214 were given prednisone and aspirin (161 autoantibody-negative and 53 autoantibody-positive women), and 63 autoantibody-negative women received aspirin alone. Autoantibodies were present in 33.9% of the patients, in 82.6% of them anticardiolipin antibodies were found to be isolated or associated with antiprothrombin, antithyroid, circulating anticoagulant, antinuclear or anti-beta2 glycoprotein 1 antibodies. In autoantibody-negative pregnant women treated by prednisone and aspirin or aspirin alone, the success rate of live births was 90.7% (146 out of 161) and 74.6% (47 out of 63) respectively (P < 0.01). In autoantibody-positive patients treated with prednisone and aspirin the success rate was 84.9% (45 out of 53) (not significant). Prednisone and aspirin seemed to be as efficient in autoantibody-negative or positive women but better than aspirin alone in autoantibody-negative women. A double-blind trial is in progress to confirm these results.

Abortion, Habitual↗

PubMed1999

A composite model of the auditory periphery for simulating responses to complex sounds.

This paper presents a phenomenological model of the cochlea. It consists of a bank of nonlinear time-varying parallel filters and an active distributed feedback. Realistic filter shapes are obtained with the all-pole gamma-tone filter (APGF), which provides both a good approximation of the far more complex wave propagation or cochlear mechanics models and a very simple implementation. Special care has been taken in modeling nonlinear properties in order to mimic the responses of the cochlea to complex stimuli. As a result, the model reproduces several observed phenomena including compression, two-tone suppression, and suppression of tones by noise. The distributed feedback, based on physiological evidence from outer hair cell (OHC) functioning, controls the damping parameter of the APGF and provides good modeling of both low-side and high-side suppression. Responses to more complex stimuli as well as a study of the model's parameters are also presented. Areas of application of this type of model include understanding of signal coding in the cochlea and auditory nerve, development of hearing aids, speech analysis, as well as input to neural models of higher auditory centers.

Auditory Perception↗

PubMed1999

The representation of pure tones and noise in a model of cochlear nucleus neurons.

The limited dynamic range of the majority of auditory-nerve fibers represents a difficulty in accounting for normal hearing capabilities over the known psychoacoustic intensity range. The presence of noise is an additional complication because it will tend to saturate these fibers, thereby considerably reducing their dynamic range, i.e., the range of mean firing rates. In this study, simulations involving a model of auditory nerve and cochlear nucleus neurons were conducted using pure-tone stimuli in the presence of noise. The main focus is on the role of inhibition in regulating the activity of cells, improving their capability to represent signals in background noise. This concerns in particular those inhibitory neurons that receive input from a wide range of auditory-nerve fibers and respond with an onset chopper pattern. A detailed model of stellate cells is used. It allows several parameters such as the number, location, and strength of inputs to be manipulated. The fist part of this paper presents the model and its responses to pure-tone and noise stimuli presented separately. The model's capacity to generalize to tone/noise combinations is then tested. Responses to these stimuli are found to be qualitatively similar to neurophysiological findings. Model neurons exhibit appropriate shifts in their rate-level functions and their responses are inhibited or suppressed by tones outside their characteristic frequency. The model stellate cell is also found to display many of the temporal patterns reported in electrophysiological studies as a result of appropriate settings of certain parameters. Therefore, the model is sufficient to account for a larger number of findings and should serve as a basis for predicting responses to novel stimuli, or as a building block for modeling larger networks.

Audiometry, Pure-Tone↗

PubMed1999

Potentiation of artemisinin activity against chloroquine-resistant Plasmodium falciparum strains by using heme models.

The influence of different metalloporphyrin derivatives on the antimalarial activity of artemisinin was studied with two chloroquine-resistant strains of Plasmodium falciparum (FcB1-Colombia and FcM29-Cameroon) cultured in human erythrocytes. This potentiation study indicates that the manganese complex of meso-tetrakis(4-sulfonatophenyl)porphyrin has a significant synergistic effect on the activity of artemisinin against both Plasmodium strains.

Animals↗

PubMed1999

Recombinant Staphylococcus strains as live vectors for the induction of neutralizing anti-diphtheria toxin antisera.

We have investigated whether the nonpathogenic gram-positive bacteria Staphylococcus xylosus and S. carnosus can display a whole domain of a toxic protein on their surface and if such vectors are suitable for immunization of BALB/c mice. The nucleotide sequence encoding the receptor-binding domain (DTR; amino acids 382 to 535) of diphtheria toxin (DT) was inserted into plasmids pSE'mp18ABPXM and pSPPmABPXM, which were designed to display heterologous proteins on S. xylosus and S. carnosus cell surfaces, respectively. Western blot analysis of the resulting bacterial lysates indicates that DTR is produced by each expression system. However, analysis of rabbit anti-DTR antisera binding to the transformed live bacteria shows that DTR is not displayed on the surface of S. xylosus cells whereas it is efficiently exposed on S. carnosus. A significant anti-DT antibody response was raised in BALB/c mice immunized intraperitoneally with S. carnosus displaying DTR, and the antisera abolished DT cytotoxicity on Vero cells. Thus, only S. carnosus can display a whole domain of a toxic protein and represents a potential vector for humoral vaccination.

Animals↗

PubMed1999

Identification of new prognosis factors from the clinical and epidemiologic analysis of a registry of 229 Diamond-Blackfan anemia patients. DBA group of Société d'Hématologie et d'Immunologie Pédiatrique (SHIP), Gesellshaft für Pädiatrische Onkologie und Hämatologie (GPOH), and the European Society for Pediatric Hematology and Immunology (ESPHI).

Diamond-Blackfan anemia (DBA) is a constitutional disease characterized by a specific maturation defect in cells of erythroid lineage. We have assembled a registry of 229 DBA patients, which includes 151 patients from France, 70 from Germany, and eight from other countries. Presence of malformations was significantly and independently associated with familial history of DBA, short stature at presentation (before any steroid therapy), and absence of hypotrophy at birth. Two hundred twenty-two patients were available for long-term follow-up analysis (median, 111.5 mo). Of these individuals, 62.6% initially responded to steroid therapy. Initial steroid responsiveness was found significantly and independently associated with older age at presentation, familial history of DBA, and a normal platelet count at the time of diagnosis. Severe evolution of the disease (transfusion dependence or death) was significantly and independently associated with a younger age at presentation and with a history of premature birth. In contrast, patients with a familial history of the disease experienced a better outcome. Outcome analysis revealed the benefit of reassessing steroid responsiveness during the course of the disease for initially nonresponsive patients. Bone marrow transplantation was successful in 11/13 cases; HLA typing of probands and siblings should be performed early if patients are transfusion dependent, and cord blood should be preserved. Incidence of DBA (assessed for France over a 13-y period) is 7.3 cases per million live births without effect of seasonality on incidence of the disease or on malformative status. Similarly, no parental imprinting effect or anticipation phenomenon could be documented in families with dominant inheritance.

Abnormalities, Multiple↗

PubMed1999

Diagnosis of acute basophilic leukemia.

De novo acute basophilic leukemia (ABL) is a rare form of acute leukemia. Most frequently, the blast cells are morphologically undifferentiated, and the recognition of the presence of coarse basophilic granules may be the first step in diagnosis of this rare disorder. These granules are metachromatic and MPO negative. Immunophenotyping shows myeloid markers and some more specifically associated antigens such as CD9 or CD25 which are strongly expressed. Lymphoid, erythroid or megakaryocytic markers are not significantly expressed. In the absence of basophilic granules, some cases are classified as AML M0 if they express myeloid markers, or undifferentiated leukemia if no markers are present. If specific immature basophilic or theta granules are present, only an electron microscopic study will enable the diagnosis of a basophilic lineage assignment. Some cases may be misdiagnosed if all these steps are not followed. After all these investigations, two types of ABL may be defined: 1-A pure ABL, monophenotypic with basophilic lineage involvement alone, which should be classified as AML M8 . Genetic studies in these cases are very important for understanding the leukemic process and in a few cases, we can suspect c-MYB oncogene involvement but further investigations are still necessary. 2- More frequently, acute leukemia can be a mixture of blasts from different lineages with an important but variable participation of mature or immature basophilic cells. These cases must be classified as AML/Baso or multiphenotypic acute leukemias and often present Phl -chromosomal abnormality.

Biomarkers↗