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作者报告一例6岁男孩在患急性粒细胞血病前9个月骨髓中发现单核和双核巨核细胞。患儿在1966年(3岁)时,第一次发现白细胞减少(3000～4000/立方毫米),血涂片中血小板数正常。但当时无症状。1967年10月患肺炎双球菌肺炎,当时白细胞总数为3100～3650/立方毫米,骨髓中主要是早期的粒细胞,但红细胞和巨核细胞系统没有明显改变。 1969年4月,患儿6岁时,因呼吸道感染发热3个星期后,发现面色苍白,血红蛋白3.6克％,血小板29.4万/立方毫米,白细胞7600/立方毫米,分类中未见幼稚细胞,胎儿血红蛋白8.2％,其他各项检查均正常,骨髓穿刺检查细胞增生中度,粒细胞系统增生,红细胞系统增生低下,巨核细胞体积小,单核或双核,胞浆中含粗大的嗜天青颗粒,这是产生血小板的巨核细胞的特征。经用输血和强的松治疗,网织红细胞从0.2％上升至6.2％,血红蛋白维持在10～12克,血小板数正常,白细胞仍低至2000～3000/立方毫米。
The authors report a 6-year-old boy who found mononuclear and binuclear megakaryocytes in the bone marrow 9 months prior to acute myeloid leukemia. Children with leukopenia (3000-4000 per cubic millimeter) were found for the first time in 1966 (3 years of age) with normal platelets in the blood smear. But then asymptomatic. October 1967 suffering from pneumococcal pneumonia, when the total number of leukocytes 3100 ~ 3650 / cubic millimeter, the main bone marrow is the early granulocytes, but the red blood cells and megakaryocyte system did not change significantly. In April 1969, when the child was 6 years old, he was pale and had 3.6 grams of hemoglobin, 294,000 per cubic millimeter of platelets, and 7600 per cubic millimeter of white blood cells after 3 weeks of fever due to respiratory infections. No naive cells were found in the classification, and fetuses Hemoglobin 8.2%, the other checks were normal, bone marrow biopsy moderate cell proliferation, hyperplasia of granulocyte system, hyperplasia of erythrocyte system is low, megakaryocyte volume is small, mononuclear or dual nucleus, cytoplasm containing coarse azurophilic granules, This is a characteristic of platelet-producing megakaryocytes. With transfusion and prednisone treatment, reticulocytes increased from 0.2% to 6.2%, hemoglobin maintained at 10 to 12 grams, platelets normal, leukocytes is still as low as 2000 ~ 3000 / cubic millimeter.