PMC5546120_01
Bone marrow smear at diagnosis showed 70%-80% cellularity with decreased megakaryocyte, increased proportion of myeloid to erythroid cells, and high level of myeloid blasts which could be presumptive of AML-M4.
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The bone marrow aspiration smear (Figure 1) revealed 70%-80% cellularity with reduced megakaryocytes and raised ratio of myeloid to erythroid cells.
Karyotype analyses showed 46 XY compatible with the apparently normal male with no chromosomal aberration on the basis of GTG technique at 350-400 band resolution.
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CD13, CD14, CD33, CD34, CD45, CD64, HLA-DR, and c-MPO supported the AML-M4 based on French-American-British classification. Cytogenetic analysis demonstrated 46 XY compatible with the apparently normal male without chromosomal abnormality (Figure 2).
Bone marrow smears at spontaneous remission (2 weeks after sepsis resolution) showed 5-10% cellularity including sufficient megakaryocytes, myeloid and elytroid cells being in various maturation phases, and no blast.
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In addition, the bone marrow smear contained 5-10% cellularity with adequate megakaryocytes for this setting, myeloid and elytroid cells being in various maturation phases, and no blasts were recognized (Figure 3).
Bone marrow smear at spontaneous remission (4 weeks after sepsis resolution) showed 50-60% cellularity including sufficient megakaryocytes, the normal ratio of myeloid to elytroid cells, and no blast.
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Two weeks later, the bone marrow biopsy was repeated and the smear revealed 50-60% cellularity with sufficient megakaryocyte, the normal ratio of myeloid to erythroid cells, and no blast (Figure 4).