China
Africa
Explore chapters and articles related to this topic
Acute Leukemia and Myelodysplastic Syndromes
Published in Harold R. Schumacher, William A. Rock, Sanford A. Stass, Handbook of Hematologic Pathology, 2019
Mark D. Brissette, James D. Cotelingam
M3 is promyelocytic leukemia, and comprises 5–10% of AML (Fig. 7, Tables 6 and 7). The abnormal promyelocytes are usually heavily granulated and have a bilobed or kidney bean-shaped nucleus with a nucleolus. Auer rods are often prominent, and some cells contain multiple Auer rods. There is also a microgranular variant. This variant has nuclear features identical to hypergranular AML M3, but granules are not apparent by light microscopy. However, granules can be visualized using electron microscopy.
SBA Answers and Explanations
Published in Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury, SBAs for the MRCS Part A, 2018
Vivian A. Elwell, Jonathan M. Fishman, Rajat Chowdhury
Reed–Sternberg cells are diagnostic for Hodgkin’s lymphoma. The Philadelphia chromosome and decreased quantities of leucocytes alkaline phosphatase are commonly observed in chronic myelogenous leukaemia. Auer rods are most often seen in increased numbers in acute myelogenous or myelomonocytic leukaemia. Pappenheimer bodies are abnormal iron granules found inside red blood cells. They are associated with sideroblastic anaemia, haemolytic anaemia, and sickle cell disease.
Case 39
Published in Atul B. Mehta, Keith Gomez, Clinical Haematology, 2017
A full clinical and radiological assessment should be undertaken. The absence of splenomegaly and virtually normal red cell morphology makes chronic myelofibrosis (which is in any event very rare at this age) unlikely. The picture is one of acute myelofibrosis, and further attempts should be made to concentrate and characterise the blast cells with flow cytometry. This may best be done from peripheral blood. The table below shows a simplified classification of acute myeloid leukemia (AML). Cytochemistry is of historic interest only; myeloid cells stain with sudan black (39a) and myelo/monocytic cells can be demonstrated with a combined esterase stain (Figure 39b). The presence of Auer rods indicates myeloid differentiation (Figure 39c). Certain morphological features are particularly associated with specific cytogenetic and clinical characteristics, for example, the translocations t(8;21) and inv 16 are seen with well-differentiated AML and AML with abnormal eosinophils, respectively, both involve the transcription factor core binding factor (CBF) and both are associated with a good prognosis. Mutations in CEBPA and NPM genes generally confer a good prognosis, while mutations in FLT3 are generally associated with a poor prognosis.
Report of a new six-panel flow cytometry marker for early differential diagnosis of APL from HLA-DR negative Non-APL leukemia
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2020
Mohammad Mosleh, Mahdieh Mehrpouri, Sasan Ghaffari, Zeinab Saei, Mahnaz Agaeipoor, Farzaneh Jadali, Esmaeil Shahabi Satlsar, Roohollah Gholampour
Due to a high risk of fatal bleeding, current protocols recommend APL to be considered as a medical urgency upon diagnosis [9]. Immunophenotyping of arrested blast cells by flow cytometry has become a rapid and reliable method of lineage determination, since it is faster and less costly than cytogenetic tests. In flow cytometry evaluation, APL blasts are CD11b negative, CD34 negative, and CD117± and positive for CD13, CD33, CD64, and cytoplasmic myeloperoxidase (MPO). MPO staining of APL blasts also shows a diffuse and strong positive patterns. The presence of Auer rods is also witnessed in the cytoplasm of said blasts. Negative expression of CD10, CD11a, CD11c, CD45RO, and CD133 is another common feature [10]. Most AML cases express HLA Class II antigens, such as HLA-DR, on the surface of their blast cells upon diagnosis, and HLA-DR expression in non-APL cases is common. APL, known to lack the HLA-DR antigen, is an exception. Lack of HLA-DR antigen expression is hence another marker used for distinguishing APL from other AML subtypes. However, data suggest that HLA-DR negativity can also be witnessed in non-M3 AML. Due to bleeding tendency in some cases of HLA-DR negative non M3-AML [11], early detection and accurate differentiation of APL is crucial to the patient’s health.
Development of acute promyelocytic leukemia in a patient with tetraplegia while in inpatient rehabilitation: A case report
Published in The Journal of Spinal Cord Medicine, 2018
Christopher A. Beal, Michael C. Krouse, Jeffrey T. Tubbs
A repeat peripheral smear was performed and demonstrated multiple blast cells with Auer rods, concerning for acute myeloid leukemia (AML), especially APL (Fig. 1). The patient was emergently transferred off the spinal cord injury unit to the medicine service for further workup and management. Since there was a high suspicion for APL, treatment was initiated with all-trans-retinoic acid (ATRA) and arsenic trioxide (ATO). APL was then confirmed with a bone marrow biopsy. He underwent treatment with ATRA and ATO including consolidation treatment. Hospital course was complicated by neutropenic fever secondary to klebsiella urinary tract infection (UTI) and adrenal insufficiency. Repeat bone marrow biopsy was performed and was suggestive of APL remission.
Early mortality continues to be a barrier to excellent survival in childhood acute promyelocytic leukemia: a retrospective study of 62 patients spanning 17 years
Published in Pediatric Hematology and Oncology, 2023
Pritam Singha Roy, Vinay Munikoty, Amita Trehan, Richa Jain, Prateek Bhatia, Shano Naseem, Neelam Varma, Deepak Bansal
Complete remission was defined as an absolute neutrophil count >1.5 × 109/L, an unsupported platelet count >100 × 109/L, and a bone marrow examination showing adequate cellularity with less than 5% blasts and absence of cells with Auer rods.14