AML M4 FAB: Acute myelomonocytic leukemia - case report 1

Author(s): S. Fuehauf, A. Pitkus
Last change: 2003/04/10

Sort of case report: In clinical view

Medical history: The patient was first diagnosed at our institution. Upon admission the patient had complaints of a night sweat for 4 weeks and difficulties swallowing for the past ten days.

Clinical Examination: A complete blood count (CBC) was ordered and showed a leukocytosis of over 60 /nl. A bone marrow biopsy and accompanying CBC were then ordered for further investigation.

Laboratory results:


Parameter	Value	Normal value [unit]
RBC	2.8	4.3-6.1 /pl
Hemoglobin	8.4	13.-17. g/dl
Hematocrit	0.24	0.38-0.52 l/l
MCV	87	83-97 fl
Plt	64	150-440 /nl
WBC	63.71	4.0-10.0 /nl
Neutrophils	0.64	1.8-7.7 /nl
Lymphocytes	6.37	1.0-4.8 /nl
Monocytes	14.02	0.2-0.8 /nl
Eosinophils		0-0.5 /nl
Differential	Results
Band Neutrophils		3-10 %
Segmented Neutrophils	1	50-70 %
Lymphocytes	10	25-40 %
Atypical Lymphs	11	0 %
Monocytes	22	2-9 %
Eosinophils		2-4 %
Basophils		0-1 %
Metamyelocytes		0 %
Myelocytes		0 %
Promyelocytes		0 %
Blasts	56	0 %
Normoblasts	2	/ 100 L

Bone Marrow	Differential	Results
Red Cell Precursors	3%
Myeloblasts	94%
Metamyelocytes	1%
Segmented Neutrophils	1%
Lymphocytes	4%

Cytogenetics: Cytogenetics testing was attempted on a bone marrow specimen. However, the chromosomal analysis did not yield any evaluable mitoses after 24 hours and 48 hours of cell culture.

Diagnosis: Acute myeloid leukemia of the M4 subtype. Immunophenotyping results are indicative of an acute myeloid leukemia with 75% blast cells.