January 2024
Monthly Digital Case Study
January Slides
AML M5a Quick Overview
Quiz
(PDF for print)
| WBC 147.22* (10^3/mm3) | Neutrophils 0.7 (%) |
| RBC 2.08* (10^6/mm3) | Lymphocytes 2.1 (%) |
| HGB 6.6* (g/dL) | Blasts 96.5 (%) |
| HCT 19.2* (%) | |
| MCV 92 (fL) | |
| MCH 31.7 (pg) | |
| MCHC 34.4 (g/dL) | |
| PLT 63 (10^3/mm3) |
Emergency? AML
Anemia.
Aniso-poikilocytoses (echinocytes++).
Neutropenia. Thrombocytopenia.
Hyperleucocytic blastosis.
Large blasts with often "bissac" nuclei.
Rarely granulated blasts (no Auer bodies seen).
Expert’s comment:
AML M5a? NPM1 mutation? Check the platelet count by manual method.
Selection of blast cells
AML M5 (Acute monocytic/monoblastic leukemia) is subclassified as either M5a or M5b depending upon the degree of monocytic maturation. M5a (Acute Monoblastic Leukemia) is characterised by having >80% monoblasts of the monocytic element, whereas M5b (acute monocytic leukemia) is where there is <80% monoblasts of the monocytic element. Monoblasts can be defined as large cells (20-30 um), with round/oval nuclear shape, prominent nucleolus, basophilic cytoplasm with some fine azurophilic granules. The nucleophosmin (NPM1) mutation is the most common genetic lesion in adult acute leukemia (present in about 1/3rd of all cases). The presence of the NPM1 Mutation and the absence of the FLT3 ITD mutation has been shown to be a favorable prognostic indicator.
Can you name this cell?
The answer will be displayed in the next QSP Newsletter and on our social media - LinkedIn / Facebook / X (Twitter).
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