PMC9709304_01
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Morphology, immunophenotyping, FISH and karyotyping. (A) An increased number of promyelocytes, which contained azurophilic granules or Auer bodies (Wright-Giemsa staining of bone marrow, x1000). (B) Leukemia cells expressed MPO, CD13, CD15, CD33, but do not express CD34, HLA-DR. (C) No PML-RARA fusion signals were detected by FISH using PML-RARA Dual Color, Dual Fusion Translocation Probe. (D) Chromosome G band analysis revealing karyotype 46,XX [20].
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Bone marrow smear: Positive for myeloperoxidase (MPO) staining, pathological promyelocytes accounting for 82%, with coarse azurophilic granules densely distributed in the cytoplasma and fagot Auer bodies present, hypergranular APL (M3) diagnosed ( Figure 1A ). Immunophenotyping: AML (expressing CD13, CD15, CD33, CD64 and MPO, but no HLA-DR, CD34, CD19 or other antigens recognized by T-cells and B-cells) ( Figure 1B ). RARA rearrangement or MLL rearrangement was not identified by fluorescence in situ hybridization (FISH) ( Figure 1C ). The patient was found with karyotype 46, XX [20] ( Figure 1D ) We did the PML-RARalpha fusion gene test (using polymerase chain reaction, PCR and FISH methods) once we suspected APL of the patient on day 1, and re-checked the results of PML-RARalpha in two different medical laboratory institutions.
PMC9709304_04
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