The haematological emergency - Promyelocytic leukaemia - Calendar 2008 month 10

Author(s): H. Diem (1), R. Hinzmann, F. Forstreuter (2)
Institution(s): (1) Würmtal-Labor, 82131 Gauting; (2) Sysmex Europe GmbH, Norderstedt - Germany
References: The Sysmex Scientific Calendar 2008;
Photos and text: Heinz Diem, MD; text: Rolf Hinzmann, MD, PhD; Frauke Forstreuter, PhD
Last change of this image collection: 2008/01/01

In promyelocytic leukaemia the myeloid blasts mature only to the stage of promyelocytes. A tentative diagnosis can be made when atypical promyelocytes - most often only a few - are found in peripheral blood. The diagnosis needs to be confirmed promptly by subsequent bone marrow puncture and morphological detection of atypical promyelocytes. They typically display Auer rods, which often appear in bundles (faggots), and the translocation t(15;17). This translocation proves AML-M3 or AML-M3v (v=variant). Diagnosis and initiation of therapy have to be carried out promptly since the patients are endangered by a strong bleeding tendency which is often due to consumptive coagulopathy.

Diagnosis of AML in the bone marrow: Characteristic are bundles of Auer rods (->) and many atypical promyelocyctes.

Typical blasts (on the right with Auer rods ->) in AML-M3v.