Acute myeloid leukemias M2 potentially misdiagnosed as M3 variant French-American-Britain (FAB) subtype: a transitional form?

Leuk Lymphoma. 1995:18 Suppl 1:49-55. doi: 10.3109/10428199509075303.

Abstract

From 1990 to 1994, 3 patients with de novo acute myeloid leukemia (AML) in whom light microscopy and cytochemistry suggested a FAB subtype M3 variant were observed at our Institute. Immunophenotype showed HLA-DR-, CD13+, CD33+, CD2+, CD9+; promyelocytic features were also detected by electron microscopy. However, leukemic cells lacked both translocation t(15;17) and RAR alpha/PML genes rearrangement. These cases were considered to be 'M2 atypical' subtypes and they contribute to point out how cytogenetics and molecular biology are mandatory for a correct diagnosis of acute promyelocytic leukemia (APL) particularly because therapy with all trans retinoic acid (ATRA) is now the best treatment for APL. Nevertheless these 3 cases indicate that the atypical M2 subtype may be confused with the M3v if only cytochemistry, immunophenotype and electron microscopy are used in the defining the FAB subtypes.

MeSH terms

  • Adult
  • Diagnosis, Differential
  • Female
  • Humans
  • Karyotyping
  • Leukemia, Myeloid, Acute / diagnosis*
  • Leukemia, Promyelocytic, Acute / diagnosis*
  • Male
  • Neoplasm Proteins*
  • Nuclear Proteins*
  • Promyelocytic Leukemia Protein
  • Receptors, Retinoic Acid / genetics
  • Retinoic Acid Receptor alpha
  • Transcription Factors / genetics
  • Translocation, Genetic
  • Tumor Suppressor Proteins

Substances

  • Neoplasm Proteins
  • Nuclear Proteins
  • Promyelocytic Leukemia Protein
  • RARA protein, human
  • Receptors, Retinoic Acid
  • Retinoic Acid Receptor alpha
  • Transcription Factors
  • Tumor Suppressor Proteins
  • PML protein, human