leukemia with unusual marker: case report of acute myeloid leukemia with aberrant marker

Introduction: Half of Leukemic cases are classified as acute leukemia and Leukemias compriseapproximately 8% of the human cancers. increase the proliferation in megakaryocytic, monocytic,granulocytic, and erythrocytic lineages is acute myelogenous leukemia (AML) Also ALL iscommonest acute leukemia in children. AML has highly variation in phenotype. TheImmunophenotyping is critical in diagnosis of AML. Acute leukemia involves approximately 4million people per year in the developed countries approximately million people per year in thedeveloped countries Immunophenotyping become widely used method to diagnose due toMorphology and Immunohistochemistry are not reliable methods. When the morphologyinterpretation is confusing to diagnose sub type, immunotyping can be extremely helpful.Materials Methods: thirty-four-year-old male presented with prolonged bleeding in Toothextractions. he has infection after that and also have recurrent bleeding presented to our Hospitalby mild fever, weight loss and loss of appetite months ago, complete blood cell count (CBC)showed leukocytosis, and mild thrombocytopenia with circulating blasts in PB smear. On admissionCBC information included the following: WBC 90×106, neutrophils 10%; lymphocytes 15%;monocytes 2%; eosinophils 1%; basophils 1%; band 2%; and 69% blasts (62.1×106/L),hemoglobin, 10 g/dL; and platelet count, 50/L peripheral blood sample was submitted for moreanalysis such as flow cytometric Immunophenotyping and morphologic. diagnosis of acutemyeloid leukemia (AML, NOS) according to WHO 2008 classification and AML M1 accordingFAB classification, with aberrant expression of CD138, CD38 was established. Unfortunately, thepatient heavy fungal infection during standard induction chemotherapy for AML.Results: Flow cytometry analysis of the patient’s peripheral blood demonstrates discrete blastpopulation gated using side scatter versus CD45. The blast cells showed positivity for CD45, HLADR, CD38, CD34, CD33, CD64 (75%), CD117 (22%), MPO is expressed only in 15% of gatedcells. CD79a, CD56, and CD7 were expressed in 44%, 70%, and 80% of the blast cells respectively.Terminal deoxynucleotidyl transferase (TdT), CD19, CD20, CD22, CD10, CD13, CD15 and T-cellmarkers were negative.Conclusion: Flow cytometric analysis of the patient’s peripheral blood repeat again after standardinduction chemotherapy for AML. The analysis shows the CD138 and CD38 are aberrant markerand the blasts are decrease in expression these markers after remission therapy. The standardtherapy for AML are effective in this patient and this shows the blasts are myeloid