A 15-years-old boy presented with one day history of bleeding gum, subconjunctival bleed and purpuric rash. Investigations revealed followed results: Hb- 6.4 gm/dl; TLC- 26500/mm3, platelet 35,000 mm3; PT -20 sec with a control of 13 sec; PTT- 50sec; and Fibrinogen 10mg/dL. Peripheral smear was suggestive of AML. Which of the following is the most likely? (AIIMS May 2010)
|A||Myeloblastic leukemia without maturation|
|B||Myeloblastic leukemia with maturation|
AML (FAB Classification) (Ref. Robbins 7th ed pg. 693)
M0 Minimally differentiated AML – Blasts myeloperoxidase negative
M1 AML without maturation – Very immature, only 3% peroxidase positive
M2 AML with maturation – most common subset, associated with t(8;21)
M3 Promyelocytic – High incidence of DIC, many Auer rods per cell patients are younger associated with(t15;17)
M4 Myelomonocytic – monoblasts are positive for nonspecific esterases, associated with the inv(16)
M5 Monocytic – occur in older patients
M6 Erythroleukemia – makes up 1% of de novo AML and 20% of therapy related AML.
M7 Megakaryocytic leukemia – Myelofibrosis seen in most cases.