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Rare variant of acute promyelocytic leukaemia
P K Mitra1, C Mukherjee, A Dasgupta
1Department of Pathology, RG Kar Medical College, Calcutta.
Abstract:
Acute promyelocytic leukaemia (APL) is a peculiar sub-type of acute myeloblastic leukaemia characterised by presence of atypical promyelocytes in bone marrow and peripheral blood and common occurrence of haemorrhagic episodes associated with disseminated intravascular coagulation. Two morphological forms of APL are recognised--typical hypergranular and microgranular or M3 variant. This microgranular form of APL is rare but has got some peculiar features and often can be diagnosed by peripheral blood smear examination alone without bone marrow examination. Three cases of microgranular form of APL observed during a period of 6 months are reported here.
Insights
Acute promyelocytic leukaemia (APL), a rare subtype of acute myeloblastic leukaemia, presents with unique microgranular features. Early diagnosis via peripheral blood smear examination is highlighted in three reported cases.
Area of Science:
- Hematology
- Oncology
- Leukemogenesis
Background:
- Acute promyelocytic leukaemia (APL) is a distinct subtype of acute myeloblastic leukaemia.
- APL is characterized by atypical promyelocytes and a high risk of bleeding due to disseminated intravascular coagulation.
- Two morphological variants exist: typical hypergranular and the rarer microgranular (M3 variant).
Observation:
- The microgranular form of APL exhibits unique clinical and morphological characteristics.
- Diagnosis of the microgranular APL variant can often be achieved through peripheral blood smear examination alone.
- Three cases of microgranular APL were observed over a six-month period.
Findings:
- The study reports three cases of the rare microgranular variant of acute promyelocytic leukaemia.
- Peripheral blood smear examination proved sufficient for diagnosing these cases, obviating the need for bone marrow biopsy.
- This highlights the diagnostic utility of peripheral smear analysis for microgranular APL.
Implications:
- Early identification of microgranular APL through peripheral blood analysis can expedite diagnosis and treatment.
- This approach may reduce the need for invasive bone marrow examinations in suspected cases.
- Further research into the specific features and management of microgranular APL is warranted.