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Morphologic and immunophenotypic features of a case of acute monoblastic leukemia with unusual positivity for

Giovanni Carulli1, Paola Sammuri1, Cristiana Domenichini1

  • 1Division of Hematology, University of Pisa.

Hematology Reports
|January 12, 2019
PubMed

Insights

This study reports a rare case of acute monoblastic leukemia (AMoL) with an unusual immunophenotype. Leukemic cells expressed both monocytic markers and Glycophorin-A, a specific marker of erythroid lineage, suggesting a common myeloid-erythroid precursor origin.

Area of Science:

  • Hematology
  • Oncology
  • Cell Biology

Background:

  • Acute monoblastic leukemia (AMoL) presents with undifferentiated morphology, posing diagnostic challenges.
  • Non-specific esterase cytochemistry can be negative in up to 20% of AMoL cases.
  • Flow cytometry immunophenotyping is crucial for accurate AMoL subtyping.

Purpose of the Study:

  • To describe a unique case of AMoL with an atypical immunophenotype.
  • To highlight the diagnostic utility of a comprehensive immunophenotyping panel.
  • To investigate the potential origin of AMoL with mixed lineage markers.

Main Methods:

  • Morphological analysis of leukemic cells.
  • Alpha-naphtyl-acetate esterase cytochemistry.
  • Multiparametric flow cytometry with an extensive monoclonal antibody panel.

Main Results:

  • Leukemic blasts exhibited monocytic markers.
  • A significant proportion of leukemic cells were positive for Glycophorin-A.
  • This Glycophorin-A expression is unprecedented in reported AMoL cases.

Conclusions:

  • The aberrant immunophenotype suggests a common myelo-erythroid precursor origin in this AMoL case.
  • This finding expands the understanding of leukemic differentiation pathways.
  • Comprehensive immunophenotyping is essential for diagnosing complex leukemia subtypes.

Keywords:
acute monoblastic leukemiacytomorphologyflow cytometryglycophorin-A

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