A Rare Case of Acute Myeloblastc Leukemia With Blast Count Less Than 20% in Bone Marrow
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Abstract
One of the diagnostic criteria for Acute Myeloblastic Leukemia (AML) is the presence of 20% myeloid blasts in peripheral blood or bone marrow. Some cases with recurrent cytogenetic abnormalities also fall in this category with blast cell count less than 20%. Thus, in the presence of these genetic abnormalities, the patients are classified as AML regardless of blast cell count. One of these genetic heterogeneities is t(8; 21) (q22, q22.1) which is more commonly seen in children and young adults. In this study, a 14-year-old boy is reported with a final diagnosis of AML, which was presented with fever and bicytopenia, clinically suspicious for acute leukemia. Laboratory results reported less than 20% blasts in bone marrow aspiration smears but genetic alteration t(8; 21) (q22, q22.1) was detected by molecular exams.
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[2] Catovsky D, Matutes E, Buccheri V, Shety V, Hanslip J, Yoshida N, et al. A classifcaton of acute leukaemia for the 1990s. Annals of Hematology February. 1991; 62(1):16-21. [DOI:10.1007/BF01714978]
[3] Jaffe ES. World Health Organizaton Classifcaton of tumours: Pathology & genetcs: Tumours of haematopoietc and lymphoid tssues. Geneva: World Health Organizaton; 2001.
[4] Vardiman JW, Thiele J, Arber DA, Brunning RD, Borowitz MJ, Porwit A, et al. The 2008 revision of the World Health Organizaton (WHO) classifcaton of myeloid neoplasms and acute leukemia: Ratonale and important changes. Blood. 2009; 114(5):937-51. [DOI:10.1182/ blood-2009-03-209262] [PMID]
[5] Bennet JM, Catovsky D, Daniel MT, Flandrin G, Galton DA, Gralnick HR, et al. Proposed revised criteria for the classifcaton of acute myeloid leukemia: A report of the French-American-Britsh cooperatve group. Annals of Internal Medicine. 1985; 103(4):620-5. [DOI:10.7326/0003- 4819-103-4-620]
[6] Bennet JM. Proposal for the recogniton of minimally differentated Acute Myeloid Leukemia (AML-M0). Britsh Journal of Haematology. 1991; 78:325-9. [DOI:10.1111/j.1365-2141.1991.tb04444.x]
[7] Swerdlow SH, Campo E, Harris NL, Jaffe ES, PileriS A, Stein H, et al. World Healt Organizaton (WHO): Classifcaton of tumors of haematopoietc and lymphoid tssues. Geneva: World Healt Organizaton; 2008.
[8] Rowe JM, Kim HT, Cassileth PA, Lazarus HM, Litzow MR, Wiernik PH, etal. Adultpatents with acute myeloid leukemia who achieve complete remission afer 1 or 2 cycles of inducton have a similar prognosis:a report on 1980 patents registered to 6 studies conducted by the Eastern Cooperatve Group. Cancer. 2010; 116(2):5012-21. [DOI:10.1002/ cncr.25263] [PMID] [PMCID]
[9] Micol JB, Duployez N, Boissel N, Pett A, Geffroy S, Nibourel O, et al. Frequent ASXL2 mutatons in acute myeloid leukemia patents with t (8;21)/RUNX1-RUNX1T1 chromosomal translocatons. Blood. 2014; 124(9):1445-9. [DOI:10.1182/blood-2014-04-571018]
[10] Wichmann C, Becker Y, Wichmann LC, Vogel V, Vojtkova A, Herglotz J, et al. Dimer-tetramer transiton controls RUNX1/ETO leukemogenic actvity. Blood. 2010; 116(4):603-13. [DOI:10.1182/blood-2009-10-248047]
[11] Campo E, Harris NL, Pileri SA, Jaffe ES, Stein H, Thiele J. World Health Organizaton classifcaton of tumors of haematopoietc and lymphoid tssues. Geneva: World Health Organizaton; 2017.
[12] Pratcorona M, Brunet S, Nomdedéu J, Ribera JM, Tormo M, Duarte R, et al. Grupo cooperatvo para el estudio y tratamiento de las leucemias agudas mieloblástcas. favorable outcome of patents with acute myeloid leukemia harboring a low-allelic burden FLT3-ITD mutaton and concomitant NPM1 mutaton: Relevance to post-remission therapy. Blood. 2013; 121(14):2734-8. [DOI:10.1182/blood-2012-06-431122]
[13] Leonard DG, Bagg A, Caliendo AM, Deerlin VM, Kaul, KL. Molecular pathology in clinical practce. Berlin: Springer; 2016.
[14] Hatlen MA, Wang L, Nimer SD. AML1-ETO driven acute leukemia: Insights into pathogenesis and potental therapeutc approaches. Medecine. 2012; 6(3):248-62. [DOI:10.1007/s11684-012-0206-6] [PMID]
[15] Paschka P. Cancer and leukemia group B. Adverse prognostc signifcance of KIT mutatons in adult acute myeloid leukemia with inv (16) and t(8; 21): A cancer and leukemia group B study. Journal of Clinical Oncology. 2006; 24:3904-11. [DOI:10.1200/JCO.2006.06.9500] [PMID]
[16] Tenen DG. Disrupton of differentaton in human cancer: AML shows the way. Nature Reviews Cancer. 2003; 3(2):89-101. [DOI:10.1038/ nrc989] [PMID]
[17] Mrózek K, Prior TW, Edwards C, Marcucci G, Carroll AJ, Snyder PJ, et al. Comparison of cytogenetc and molecular genetc detecton of t (8; 21) and inv (16) in a prospectve series of adults with de novo acute myeloid leukemia: A Cancer and Leukemia Group B Study. Journal of Clinical Oncology. 2001; 19(9):2482-92. [DOI:10.1200/JCO.2001.19.9.2482] [PMID]
| Files | ||
| Issue | Vol 4 No 1 (2019): Winter | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/crcp.v4i1.1298 | |
| Keywords | ||
| Acute myeloblastic leukemia Bone marrow examination Cytogenetic abnormality | ||
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How to Cite
1.
Nematollahi P, Sabaghi B, Moafi A. A Rare Case of Acute Myeloblastc Leukemia With Blast Count Less Than 20% in Bone Marrow. CRCP. 2019;4(1):1-4.
