PMC7426566_01
Light micrographs of studied samples. A and B: peripheral blood smear showing promyelocytes (arrow). C: bone marrow biopsy showing promyelocytes with convoluted nucleus (arrow). D: bone marrow core biopsy showing hypercellular bone marrow with predominance of promyelocytes.
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Peripheral blood smear showed circulating abnormal promyelocytes with bilobed nuclei at 60% without Auer rods (Fig. 1:A-C). After referral to a higher-level center, bone marrow was done (Fig. 1:D) and the diagnosis of APL was confirmed by molecular and cytogenetics.
Blood parameters levels during patient's hospitalization. WBC count was stabilized after treatment with isotretinoin (30 mg po bid).
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ATRA, the patient received isotretinoin (Accutane) at dose 30 mg po bid (about 0.6 mg/kg/day) started after 48 h of presentation. After 5 days, the WBC count trended down, and blasts were not further detected (Fig. 2).