alexa
Reach Us +44-1647-403003
A Case of Hypergranular Acute Promyelocytic Leukemia (French- American-British Classification M3) | OMICS International
ISSN: 2165-7920
Journal of Clinical Case Reports
Make the best use of Scientific Research and information from our 700+ peer reviewed, Open Access Journals that operates with the help of 50,000+ Editorial Board Members and esteemed reviewers and 1000+ Scientific associations in Medical, Clinical, Pharmaceutical, Engineering, Technology and Management Fields.
Meet Inspiring Speakers and Experts at our 3000+ Global Conferenceseries Events with over 600+ Conferences, 1200+ Symposiums and 1200+ Workshops on Medical, Pharma, Engineering, Science, Technology and Business

A Case of Hypergranular Acute Promyelocytic Leukemia (French- American-British Classification M3)

Samuel J Kallus* and Neil Batta George
Georgetown University Hospital, USA
George Washington University School of Medicine and Health Sciences, USA
Corresponding Author : Samuel J Kallus
George Washington University School
of Medicine and Health Sciences, USA
E-mail: [email protected]
Received March 27, 2015; Accepted March 29, 2015; Published March 31, 2015
Citation: Kallus SJ, George NB (2015) A Case of Hypergranular Acute Promyelocytic Leukemia (French-American-British Classification M3) Neil Batta, MS3. J Clin Case Rep 5:i105. doi:10.4172/2165-7920.1000i105
Copyright: © 2015 Kallus SJ, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Visit for more related articles at Journal of Clinical Case Reports

Abstract

67-year-old male with no significant medical history was admitted with complaints of chronic fatigue, splenomegaly, and gingival bleeding for the past six months. On admission, our patient was pancytopenic with a critical platelet count of 15 K and mean corpuscular volume of 102. Work-up for medication-induced, infectious, and malignant etiologies were pursued.

Clinical Image
67-year-old male with no significant medical history was admitted with complaints of chronic fatigue, splenomegaly, and gingival bleeding for the past six months. On admission, our patient was pancytopenic with a critical platelet count of 15K and mean corpuscular volume of 102. Work-up for medication-induced, infectious, and malignant etiologies were pursued. A peripheral blood smear (Figure 1) and bone marrow aspirate (Figure 2) were obtained revealing characteristic promyelocytes with multiple Auer rods (faggot cells) on smear and increased immature granulocytes, as seen on aspirate, indicative of the hypergranular form of acute promyelocytic leukemia (FAB-M3) [1]. The patient was started on induction therapy using all-trans retinoic acid (ATRA) and concurrent arsenic trioxide therapy after
48 hours [2]. Additional concerns for differentiation syndrome, due to hyperleukocytosis [3], and disseminated intravascular coagulation (DIC) [4] were present and monitored closely. Follow up cytology confirmed t(15;17,q22,q12) promyelocytic leukemia and retinoic acid receptor-alpha (PML:RARA) gene translocation. Our patient was transfused with leukocyte-reduced platelets, cryoprecipitate [3], and packed red blood cells as needed until appropriate blood counts were attained. Due to the precipitous rise in WBC count (from 2K to 72K), the patient was transitioned to ATRA plus anthracyclin-based (e.g., daunorubicin, cytarabine) chemotherapy in place of arsenic trioxide. Total therapy includes two cycles of additional consolidation treatment and ATRA maintenance [5].
References

Figures at a glance

Figure Figure
Figure 1 Figure 2
Select your language of interest to view the total content in your interested language
Post your comment

Share This Article

Article Usage

  • Total views: 12219
  • [From(publication date):
    March-2015 - Feb 28, 2020]
  • Breakdown by view type
  • HTML page views : 8432
  • PDF downloads : 3787
Top