
Rajkumari Banashree Devi
Jawaharlal Nehru Institute of Medical Sciences, IndiaPresentation Title:
Immunophenotypic & clinico-hematological characteristics of de-novo acute promyelocytic leukemia cases detected over 5-year period in a tertiary hospital in Manipur, India
Abstract
Introduction: Acute myeloid leukemia (AML) is a genetically heterogeneous malignancy & most common subtype of leukemia in adults characterized by rapid progression and poor prognosis. Acute promyelocytic leukemia (APML) is a subtype of AML in which abnormal promyelocytes predominate and usually presents with t(15;17) (q22;q11-12), PML-RARA. APML accounts for 5-8% of AML cases, common in younger patients, with a lower relative frequency in elderly patients. Dreaded complications are disseminated intravascular coagulation and increased fibrinolysis. However, if detected early, the malignancy has very good prognosis. Flowcytometric & molecular genetic analyses are indispensable for fast diagnosis of these cases.
Materials & methods: Retrospective study conducted at Pathology department, JNIMS, Data were retrieved from all registers maintained in the Department of Pathology, between 2020-2024. Reports of flowcytometric analysis done with Beckman coulter analyzer were collected along with the molecular genetic analysis reports. Prior approval of the Institute Ethics committee was taken.
Results: Out of 22 cases diagnosed as APML from either peripheral blood smear or Bone marrow aspirate and biopsy samples. Median age of presentation was 39 years. Male: Female distribution was 1:2. The flowcytometry was carried on all 22 cases among which 14 were processed from Bone marrow aspirate samples and rest 8 cases from Peripheral blood sample. Flowcytometric immunophenotyping showed positivity for CD45, CD13, CD33, and MPO in all cases whereas CD117 positivity was noted in 90%, CD64 in 73% & CD38 in 64%. All cases were negative for CD34, HLA-DR, CD19, cCD22, CD79a, cCD3 & other T cell markers.
All of the APML cases have PML-RARA translocation. Conclusion: This study is mainly conducted because it is very crucial for timely diagnosis & early intervention in APML for a good outcome. Any delay in diagnosis & treatment lead to very poor outcome. Timely intervention in fact gives almost near normal lifespan for the patient.
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