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"Microgranular" acute promyelocytic leukemia: a distinct clinical, ultrastructural, and cytogenetic entity

H M Golomb, J D Rowley, J W Vardiman

    Blood
    |February 1, 1980
    PubMed

    Insights

    This study identifies a new subtype of acute promyelocytic leukemia, termed "microgranular" acute promyelocytic leukemia, characterized by smaller granules not visible with light microscopy. This finding highlights a distinct clinical, ultrastructural, and cytogenetic entity in leukemia patients.

    Area of Science:

    • Hematology
    • Oncology
    • Cell Biology

    Background:

    • Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia.
    • A characteristic translocation, t(15;17), is associated with APL.
    • Disseminated intravascular coagulation (DIC) is a common complication in APL.

    Observation:

    • Three patients presented with acute leukemia, DIC, and the t(15;17) chromosome abnormality.
    • Transmission electron microscopy revealed promyelocyte-like granules in these patients.
    • The average granule sizes (120-180 nm) were below the resolution limit of light microscopy (250 nm).

    Findings:

    • The observed granule size suggests a distinct ultrastructural morphology.
    • This morphology differentiates these cases from typical APL.
    • The term 'microgranular' acute promyelocytic leukemia is proposed for this entity.

    Implications:

    • Recognition of this microgranular variant is crucial for accurate diagnosis.
    • This classification may impact treatment strategies and prognosis.
    • Further research into the pathogenesis of microgranular APL is warranted.

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