Exam 26: Acute Myeloid Leukemias

Which of the following laboratory findings would be most consistent with this clinical picture?

Which of the following differentiates an AL and an MPN?

A bone marrow sample is sent to the lab for cytochemical staining. MPO, SBB, and nonspecific esterase (NSE) have been ordered. Staining results come back as follows: MPO: positive SBB: positive NSE: positive Based on these findings, what lineage(s) is(are) most likely affected?

A bone marrow review on a 15-year-old girl with acute leukemia revealed many blasts with the following characteristics: high N:C ratio, prominent nucleoli, open chromatin pattern, and basophilic cytoplasm. Cytochemical staining revealed negative reactivity with MPO and SBB. Nonspecific esterase was positive. No cytogenetic abnormalities were detected. What is the most likely lineage of the blast cells in question?

Flow cytometry has also been ordered on this patient. Which of the following markers will stain positive in this case?

Immunophenotyping is ordered on a bone marrow aspirate from a newly diagnosed patient with leukemic blasts. What panel of markers could differentiate AML from ALL?

Explain how bone marrow analysis helps establish an AML diagnosis.

A laboratory professional reviewed the CBC of a patient who had a WBC count of 5 × 10³/μL with 32% blasts present. Follow up testing with cytogenetics revealed t(15;17)(q22;q12). Which of the following is a likely diagnosis for the patient?

An APL patient has been undergoing ATRA therapy for the last 5 weeks. A repeat bone marrow and cytogenetic analysis is performed at the end of the treatment cycle. Bone marrow shows no evidence of leukemic cells, and cytogenetic anomalies were not detected. Based on this information, what is the patient's status?

A laboratory professional notes single azurophilic needlelike inclusions in the cytoplasm of many of the circulating blasts while reviewing a blood smear of an AML patient. What is the most probable identification of the inclusion?

Predict the typical platelet concentration of a patient with AML.

An acute leukemia patient presents with blast morphology that is of neutrophil lineage with Auer rods and pseudo-Pelger-Huët nuclei, myeloperoxidase, and Sudan Black B. Cytogenetic analysis reveals a t(8;21)(q22;q22) translocation in the majority of the blasts. Which classification of AML best fits this morphology, immunophenotyping, and cytochemistry?

Patients with acute myelomonocytic leukemia are at higher risk of infection compared with individuals with acute myelocytic leukemia with differentiation. Explain why there is a higher risk of infection in patients diagnosed with acute myelomonocytic leukemia.

Why are Auer rods seen only in myeloblasts?

Which acute leukemia is characterized by a blast population with both myeloid and monocytic markers on the same cell?

A patient presents with a morphological smear examination revealing >20% blasts with prominent granules and Auer rods, MPO, and SBB positive. A 25% monocyte count was seen in the peripheral smear. There were no recurrent cytogenetic abnormalities observed. Under which classification of acute leukemia, not otherwise specific, does this diagnosis fall?