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A case of acute promyelocytic leukemia with morphologic multilineage dysplastic changes

Setsuki Isono, Katsuyasu Saigo, Keiko Nagata, Keiko Numata, Toshiaki Kojitani, Akiharu Okamura, Akihiko Nishizawa, Masafumi Takata, Mariko Takenokuchi, Eiji Tatsumi
  • Setsuki Isono
    Clinical Laboratory, Kakogawa West City Hospital, Japan
  • Katsuyasu Saigo
    Faculty of Pharmacological Sciences, Himeji Dokkyo University, Japan | ksaigo@himeji-du.ac.jp
  • Keiko Nagata
    Clinical Laboratory, Kakogawa West City Hospital, Japan
  • Keiko Numata
    Clinical Laboratory, Kakogawa West City Hospital, Japan
  • Toshiaki Kojitani
    Clinical Laboratory, Kakogawa West City Hospital, Japan
  • Akiharu Okamura
    Section of Pathology, Kakogawa West City Hospital, Japan
  • Akihiko Nishizawa
    Section of Internal Medicine, Kakogawa West City Hospital, Japan
  • Masafumi Takata
    Faculty of Pharmacological Sciences, Himeji Dokkyo University, Japan
  • Mariko Takenokuchi
    Section of Internal Medicine, Kakogawa West City Hospital, Japan
  • Eiji Tatsumi
    Department of Nutrition and Health, Sagami Women’s University, Japan

Abstract

Although reports of typical acute promyelocytic leukemia (APL) cases rarely mention dysplastic changes, this report concerns a rare case of APL with tri-lineage dysplastic changes resembling the characteristic features of myelodysplastic syndrome (MDS). The patient, a 77-year-old Japanese male, was diagnosed as having pancytopenia with hematologic morphological abnormalities comprising micromegakaryocytes, neutrophils with hypo-granulation and negative peroxidase activity, and erythroblasts containing nuclei with abnormalities such as karyorrhexis. Although there is one report of a case of transformation of de novo MDS into APL and several reports of cases of therapy-related MDS transformed into APL, our patient had no history of cytopenia or of either chemo or radiation therapy. Our case can thus be considered to constitute a rare case of APL with dysplastic morphology.

Keywords

acute promyelocytic leukemia, dysplasia, all-trans retinoic acid

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Submitted: 2012-09-19 08:48:33
Published: 2013-02-15 10:51:20
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