Diagnosis for Cells Case #18: Acute Promyelocytic Leukemia (APL)

Acute promyelocytic leukemia, commonly called APL, is a form of acute myeloid leukemia caused by a specific chromosome translocation t(15;17).  It’s a malignancy of the bone marrow in which there is a deficiency of mature blood cells in the myeloid line of cells and an excess of immature cells called promyelocytes. The signs and symptoms of APL are nonspecific and include fatigue, minor infections, or hemorrhagic diathesis. There is usually pancytopenia with anemia, low levels of the granulocytes and monocytes, and low levels of platelets.  Currently it is one of the most treatable forms of leukemia with a 12-year progression-free survival rate that is estimated to be approximately 70%.

In this case, flowcytometry showed the blast cell population positive for CD117, 13/33, MPO and negative for CD34 and HLA-DR. PML-RAR staining was positive and subsequent cytogenetic analysis revealed the presence of 46,XY,t(15;17)(q24;q21), confirming the diagnosis Acute Promyelocytic Leukemia (APL). ATRA-treatment was started immediately in an academic hospital setting.

Thank you input – please don’t forget that you are most welcome to contact us if you would like to share one of your interesting or challenging cases on the blog!

/ The CellaVision Blog Team

About the CellaVision Blog

This blog is created by CellaVision for laboratory professionals with a particular interest in hematology and digital cell morphology. Our aim is to inform, educate and inspire in equal measures – by highlighting interesting articles, sharing interesting patient cases and cell images, and presenting inspiring success stories from our community of CellaVision-users from around the world.

One thought on “Diagnosis for Cells Case #18: Acute Promyelocytic Leukemia (APL)”

  1. Absolutely awesome!! I have not seen this morphologic picture in years. Rarely do you see this, (the dumb-bell nuclear shaped) promyeloblasts. Truely, leukemic promyelocytes.

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