Association of 3q21q26 syndrome and late-appearing Philadelphia chromosome in acute myeloid leukemia

Diagnosis of rare subtypes of acute myeloid leukaemia and related neoplasms

The diagnosis of acute myeloid leukaemia and related neoplasms in adults is challenging as this requires the integration of clinical findings, morphology, immunophenotype, cytogenetics, and molecular genetic findings. Lack of familiarity with rare subtypes of acute leukaemia hinders the diagnosis. In this review, we will describe diagnostic findings of several rare acute myeloid leukaemias and related neoplasms that primarily occur in adults including information on presentation, morphology, immunophenotype, genetics, differential diagnosis, and prognosis. Leukaemias discussed include blastic plasmacytoid dendritic cell neoplasm, acute myeloid leukaemia with t(6;9) (p23;q34.1); DEK-NUP214, acute myeloid leukaemia with inv(3)(q21.3q26.2) or t(3;3)(q21.3;q26.2); GATA2, MECOM, acute myeloid leukaemia with BCR-ABL1, acute leukaemias of ambiguous lineage, acute myeloid leukaemia with mutated RUNX1, pure erythroid leukaemia, acute panmyelosis with myelofibrosis, and acute basophilic leukaemia. Case studies with morphological features of the nine subtypes of acute myeloid leukaemia and related neoplasms have been included, and additional evidence available since publication of the 2016 World Health Organization Classification has been added to each subtype.

Philadelphia Chromosome-Positive De Novo Acute Myeloid Leukemia Treated With Chemotherapy and Second-Generation Tyrosine Kinase Inhibitor

Philadelphia chromosome-positive Acute Myeloid Leukemia (AML) is a de novo acute leukemia in which patients show no evidence of Chronic Myeloid Leukemia (CML) before or after their treatment. This kind of leukemia has an aggressive clinical course, with poor response to traditional chemotherapy or monotherapy with Tyrosine Kinase Inhibitors (TKI), and a high risk of early relapse after induction therapy. We report a rare case of de novo ALM with t(9;22). A 26-year-old male patient was referred to our hospital for an examination of anemia, thrombocytopenia (hemoglobin 5.7 g/dL and platelets 110 000/L) and elevated White Blood Cell (WBC) count (11 600 μ/L, 24% segmented, 63% lymphocytes, 11% monocytes). Bone marrow smear was compatible with AML. Cytogenetic study revealed t(9;22)(q34;q11). Our patient was treated with chemotherapy for AML and a second-generation TKI and remains in complete remission pending a bone marrow transplant.