Jurnal Internasional B & B: basofil dan perdarahan, sebuah kasus atipik akut leukemia promyelocytic

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Jurnal Internasional B & B: basofil dan perdarahan, sebuah kasus atipik akut leukemia promyelocytic

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A 59-year-old woman was hospitalized for an examination of spontaneous bruises in the arms and legs and asthenia. Complete blood count and review of blood smear showed pancytopenia (78 × 10 thrombocyte 9 / L, hemoglobin concentration of 10.6 g / dL, leukocytes 1.8 × 10 9 / L) with 10% blast cells and 13% basophils (0.2 × 10 9 / L). Coagulation tests, including fibrinogen and D-dimer, are normal. Bone marrow examination showed 64% hypergranular explosions with Auer stems (panels A and B, black arrows; original × 100 enlargement, May-Grünwald Giemsa staining), typical acute promyelocytic leukemia (APL) and 13% basophils with abnormal features: hypergranularity and partition abnormal granular (red arrow). Flow cytometry (panel C) confirms the typical profile of promyelocytic cells (cMPO + CD34 [19459199] – HLA DR CD117 + CD33 + CD13 [1945910] + CD123 [19459199] – ) and basophils (CD11b + CD25 + CD123 + CD13 + CD33 [1945995] + CD44 + ) with an abnormal immunophenotypic profile (CD38 CD117 low ). Cytogenetic analysis (panel D) reveals t (15; 17) (q24; q21), and molecular analysis shows classic PML-RARA transcripts. Classic APL care is provided. Basophilia increased to 0.39 × 10 / L on day 19 and normalized on day 24. Patients had started their first consolidation without problems.

Basophilia when APL diagnosis is very rare. This case highlights that basophilia can be associated with APL clones. Basophilia in APL presentations has been reported and is said to have an increased risk of bleeding, not seen in these patients.

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