Page 1117 - Williams Hematology ( PDFDrive )
P. 1117
1092 Part VIII: Monocytes and Macrophages Chapter 69: Disorders of Monocytes 1093
TISSUE EFFECTS OF MONOCYTOSIS the immune response of older individuals (Chap. 9). Dendritic cells are
Benign monocytosis is not associated with specific clinical manifes- also profoundly decreased in patients with hairy cell leukemia and are
tations. All forms of myelogenous leukemia with a predominance of dysfunctional in patients with chronic lymphocytic leukemia.
monocytes are associated with a predisposition to troublesome tissue
infiltrates, especially in the skin, gingiva, lymph nodes, meninges, and REFERENCES
anal canal. The higher the monocyte count and the higher the propor-
tion of leukemic monocytes, the more prevalent is tissue infiltration. 1. Twomey JJ, Douglas CC, Sharkey O Jr: The monocytopenia of aplastic anemia. Blood
In some cases, the tissue infiltration of leukemic monocytes can pro- 41:187, 1973.
duce symptoms: lung dysfunction, laryngeal obstruction, and intracra- 2. Bourguin-Plonquet A, Rouard H, Roudot-Thoraval F: Severe decrease in peripheral
blood dendritic cells in hairy cell leukaemia. Br J Haematol 116:595, 2002.
nial vessel rupture, as well as others. Release of procoagulants leading 3. Hsu AP, Sampaio EP, Khan J, et al: Mutations in GATA2 are associated with the autoso-
to intravascular coagulation also occurs in myelogenous leukemia with mal dominant and sporadic monocytopenia and mycobacterial infection (MonoMAC)
syndrome. Blood 118:2653, 2011.
a high proportion of monocytes. The hyperleukocytic syndrome can 4. Camargo JF, Lobo SA, Hsu AP, et al: MonoMAC syndrome in a patient with a GATA2
occur in acute monocytic leukemia with markedly elevated white cell mutation: Case report and review of the literature. Clin Infect Dis 57:697, 2013.
counts (Chaps. 83 and 88). 5. Spinner MA, Sanchez LA, Hsu AP, et al: GATA2 deficiency: A protean disorder of
hematopoiesis, lymphatics and immunity. Blood 123:809, 2014.
6. Cuellar-Rodriguez J, Gea-Banacloche J, Freeman AF, et al: Successful allogeneic
EFFECTS OF HISTIOCYTOSIS hematopoietic stem cell transplantation for GATA2 deficiency. Blood 118:3715, 2011.
7. Dickinson RE, Milne P, Jardine L, et al: The evolution of cellular deficiency in GATA2
Hemophagocytic lymphohistiocytosis usually refers to the accumu- mutation. Blood 123:863, 2014.
lation of activated macrophages (histiocytes) in tissue sites. The cells 8. Fauci AS, Dale DC: The effect of in vivo hydrocortisone on subpopulations of human
lymphocytes. J Clin Invest 53:240, 1974.
become intensely cytophagocytic; ingestion of red cells and occasion- 9. Viegas LR, Hoijman E, Beato M, Pecci A: Mechanisms involved in tissue-specific apop-
ally of leukocytes, platelets, erythroblasts in marrow, or cells in other tosis regulated by glucocorticoids. J Steroid Biochem Mol Biol 109:273, 2008.
tissue sites is an important feature of these inflammatory histiocytoses 10. Maldonado GE, Hanlon DG: Monocytosis. Mayo Clin Proc 40:248, 1965.
(Chap. 71). Because morphology has been misleading, the diagnosis of 11. Lippi G, Banfi G, Montagnana M, et al: Acute variation of leucocytes counts following
a half-marathon run. Int J Lab Hematol 32:117, 2010.
histiocytosis requires identification of specific cell markers. A histiocy- 12. Jaworkowsky LI, Solovey DY, Rhausova LY, Udris OY: Monocytosis as a sign of subse-
tosis may be inflammatory (polyclonal) or neoplastic (clonal). Because quent leukemia in patients with cytopenias (preleukemia). Folia Haematol Int Mag Klin
tissue macrophages can take on highly specialized phenotypes and Morphol Blutforsch 110:395, 1983.
localize in different tissues, histiocytosis is further defined by whether 13. Rigolin GM, Cuneo A, Roberti MG, et al: Myelodysplastic syndrome with monocytic
component: Hematologic and cytologic characterization. Haematologica 82:25, 1997.
they carry markers of these cell types (e.g., Langerhans cells, interdigi- 14. Haferlach T, Schoch C, Schnittger S, et al: Distinct genetic patterns can be identified in
tating dendritic cells; Chap. 71). acute monoblastic leukaemia (FAB AML M5a and M5b): A study of 124 patients. Br J
Haematol 118:426, 2002.
15. Villeneuve P, Kim DT, Xu W, et al: The morphological subcategories of acute monocytic
THROMBOATHEROGENESIS leukemia (M5a and M5b) share similar immunophenotypic and cytogenetic features
and clinical outcomes. Leuk Res 32:269, 2008.
The complex interrelationships among monocytes, atherogenesis, and 16. de Fonseca LM, Brunetti IL, Campa A, et al: Assessment of monocytic component in
coagulation are discussed in several other chapters in the text (Chaps. acute myelomonocytic and monocytic/monoblastic leukemias by a chemolumines-
cence assay. Hematol J 4:26, 2003.
115 and 134). Monocytes may play a central role in the pathologic 17. Ferran M, Gallardo F, Ferrer AM, et al: Acute myeloid dendritic cell leukaemia with
aspects of both processes, as a repository for tissue factor, inflammatory specific cutaneous involvement: A diagnostic challenge. Br J Dermatol 158:1129, 2008.
cytokines, and a key element in the inflammatory precursor lesions of 18. Santiago-Schwartz F, Coppock DL, Hindenberg AA, Kern J: Identification of a malig-
atheroma formation (Table 69–1, sections VIII and IX). nant counterpart of the monocytic-dendritic cell progenitor in an acute myeloid leukemia.
Blood 84:3054, 1994.
19. Srivastava HI, Srivistava A, Srivastava MD: Phenotype, genotype and cytokine produc-
BLOOD DENDRITIC CELLS tion in acute leukemia involving progenitors of dendritic Langerhans’ cell. Leuk Res
18:499, 1994.
20. Ferraris AM, Broccia G, Meloni T, et al: Clonal origin of cells restricted to monocytic
Dendritic cells and macrophages belong to a family of antigen-presenting differentiation in acute nonlymphocytic leukemia. Blood 64:817, 1984.
cells and in the laboratory can be generated from a common precur- 21. Beran M: Chronic myelomonocytic leukemia. Cancer Treat Res 142:107, 2008.
sor. So-called monocyte-derived dendritic cells are easily produced 22. Onida F, Kantarjian HM, Smith TL, et al: Prognostic scoring factors and scoring sys-
tems in chronic myelomonocytic leukemia: A retrospective analysis of 213 patients.
in the culture vessel by the appropriate cytokines. Indeed, the use of Blood 99:840, 2002.
GM-CSF as an adjuvant in cancer vaccines may relate in part to the 23. Kratz CP, Niemeyer CM: Juvenile myelomonocytic leukemia. Hematology 1:100, 2005.
cytokine’s ability to activate monocytes and foster conversion to den- 24. Del Fattore A, Cappariello A, Teti A: Genetics, pathogenesis and complications of oste-
opetrosis. Bone 42:19, 2008.
dritic (antigen-presenting) cells in vivo (Chaps. 26 and 27). Dendritic 25. Helfrich MH: Osteoclast diseases. Microsc Res Tech 61:514, 2003.
cells can be defined by phenotype into two principal types—myeloid 26. Aricò M, Janka G, Fischer A, et al, for the FHL Study Group of the Histiocyte Society:
and lymphoid (plasmacytoid) dendritic cells—of which there are likely Hemophagocytic lymphohistiocytosis. Report of 122 children from the international
registry. Leukemia 10:197, 1996.
subtypes. Monocyte-derived dendritic cells are a subset of the myeloid 27. Janka GE: Familial and acquired hemophagocytic lymphohistiocytosis. Eur J Pediatr
type (Chap. 20). 166:95, 2007.
Flow cytometry using cluster of differentiation (CD) markers and 28. Filipovich AH: Hemophagocytic lymphohistiocytosis and related disorders. Curr Opin
Allergy Clin Immunol 6:410, 2006.
antidendritic cell surface antibodies have permitted the enumeration 29. Rosado FG, Kim AS: Hemophagocytic lymphohistiocytosis: An update on diagnosis
of myeloid (human leukocyte antigen-D related [HLA-DR]+, CD11c+, and pathogenesis. Am J Clin Pathol 139:713, 2013.
CD123–) and lymphocytic-plasmacytoid (HLA-DR+, CD11c–, 30. Rouphael NG, Talati NJ, Vaughan C, et al: Infections associated with haemophagocytic
CD123+, CD303+) dendritic cells in human blood in normal subjects syndrome. Lancet Infect Dis 7:814, 2007.
and subjects with disease. Their centrality in the immune response as 31. Mehta RS, Smith RE: Hemophagocytic lymphohistiocytosis (HLH): A review of litera-
ture. Med Oncol 30:740, 2013.
premier antigen-presenting cells may result in nonspecific alterations in 32. Janka GE: Hemophagocytic syndromes. Blood Rev 21:245, 2007.
their blood concentration or function in many generalized or localized 33. Imashuku S: Clinical features and treatment strategies of Epstein-Barr virus-associated
hemophagocytic lymphohistiocytosis. Crit Rev Oncol Hematol 44:259, 2002.
inflammatory, infectious, and neoplastic diseases. Plasmacytoid den- 34. Grom AA: Macrophage activation syndrome and reactive hemophagocytic lymphohis-
dritic cells may be decreased in numbers with aging, further impairing tiocytosis: The same entities? Curr Opin Rheumatol 15:587, 2003.
Kaushansky_chapter 69_p1089-1094.indd 1092 9/18/15 9:47 AM

