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What is A 15-year-old boy presented with one day history of bleedig gums, subconjunctival bleed and purpuric rash. Investigations revealed the following results:Hb-6.4 gm/dL; TLC-26,500/mm3 Platelet 35,000 mm3; prothrombin time-20 sec with a control of 13 sec; paial thromboplastin time-50sec; and Fibrinogen 10mg/dL. Peripheral smear was suggestive of acute myeloblastic leukemia. Which of the following is the most likely - and explain in detail?
Ans. is 'c' i.e. promyelocytic leukemia o The child presents with acute onset of bleeding, along with the following laboratory anamolies. (i) Thrombocytopenia (iii) Increased paial thromboplastin time. (ii) Increased prothrombin time (iv) Decreased Fibrinogen o These hematological abnormalities indicate Disseminated intravascular coagulation o The peripheral blood smear of the patient is suggestive of acute myeloblastic leukemia (mentioned in the question) The AML most likely to occur in this setting is promyelocytic leukemia as it is the most common myeloid leukemia assciated with DIC o Promyelocytic (AML-M3) leukemic promyelocytes liberate tissue thromboplastin leading to disseminated intravascular coagulation.