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Myelodysplasia-associated acute myelogenous leukemia without differentiation (M1)
Bone Marrow, Iliac Crest
Haematoxylin & Eosin (H&E)
23 years
Acute myelogenous leukemia without differentiation (M1) prior to allogeneic stem-cell transplantation. Bone marrow trephine taken four months earlier showed 90% blastic infiltration followed by a cycle of induction therapy. Bone marrow trephine taken three months earlier revealed a refractory disease with 30% blasts.
Hypercellular bone marrow trephine. Diffuse infiltration by a blastic neoplasia. Blasts appear medium-sized to big and with abundant cytoplasm and a lack of granulocytic maturation. Low-grade myelofibrosis is apparent.
Blasts stain positive for myeloid lineage markers like CD33 and in 10% CD117. CD34, a marker indicative of early hematopoietic lineage, is only expressed by a small fraction of blasts. Intriguingly, single megakaryocytes stain positive for CD34 hinting dysplasia.
Patients suffering from acute myelogenous l leukemia present with symptoms of bone marrow failure. Common findings are anemia related fatigue, a bleeding tendency due to thrombocytopenia and frequent infections outlining a severe neutropenia. In terms of morphology blasts may display Auer rods, clumps of azurophilic granular cytoplasmic material.
Kaya Veelken, University of Basel
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