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Updated: Aug 10, 2026
Comprehensive Protocol to Sample and Process Bone Marrow for Measuring Measurable Residual Disease and Leukemic Stem Cells in Acute Myeloid Leukemia
Published on: March 5, 2018
[Acute myelomonocytic leukemia with inv (16) (p13 q22) disappeared abnormal karyotype during complete remission]
Insights
This case study details acute myelomonocytic leukemia with eosinophilia (M4Eo) in a young man. Treatment led to complete remission and normalization of bone marrow findings, including the disappearance of the inv(16) chromosomal abnormality.
Area of Science:
- Hematology
- Oncology
- Genetics
Background:
- Acute myelomonocytic leukemia with eosinophilia (M4Eo) is a rare subtype of acute myeloid leukemia.
- The inv(16)(p13q22) chromosomal abnormality is a recurrent genetic alteration associated with M4Eo.
- Early diagnosis and appropriate treatment are crucial for patient outcomes.
Observation:
- A 21-year-old male presented with anorexia and malaise, exhibiting leukocytosis with 72% leukemic cells.
- Bone marrow analysis revealed 76.8% immature monocytes and 10% eosinophils, with leukemic cells positive for myeloperoxidase and naphthylbutyrate esterase.
- Elevated urinary lysozyme activity and the presence of 46,XY,inv(16)(p13q22) were noted.
Findings:
- The patient was diagnosed with acute myelomonocytic leukemia with eosinophilia (M4Eo) associated with inv(16)(p13q22).
- One course of DCMP induction therapy resulted in complete remission.
- Post-treatment bone marrow examination showed the disappearance of the inv(16) abnormality and reduced residual leukemic cells.
Implications:
- This case highlights the successful treatment of M4Eo with inv(16) using DCMP induction therapy.
- The resolution of the chromosomal abnormality upon remission suggests its role in leukemogenesis.
- Further research into the prognostic significance of inv(16) in M4Eo is warranted.
Abstract:
A 21-year-old man was admitted to our hospital because of anorexia and general malaise in July, 1988. On admission, the white blood cell count of 18,600/microliters with 72% leukemic cells. The bone marrow aspirate showed 76.8% immature monocytes, 10% mature and immature eosinophils. Leukemic cells were 66.6% myeloperoxidase positive cells, and 20.6% naphthylbutyrate esterase positive cells. The lysozyme activity in urine was high. Cytogenetic analysis revealed the presence of 46 XY inv (16) (p13 q22). Under the diagnosis of acute myelomonocytic leukemia with eosinophilia (M4Eo) associated with inv (16) (p13 q22), one course of DCMP induction therapy was performed. After complete remission, the bone marrow aspirate showed disappearance of inv (16) (p13 q22), and associated with decreased residual leukemic cells.
