Acute myeloblastic leukemia with maturation is characterized by the presence of ≥ 20% blasts in the bone marrow or peripheral blood with evidence of maturation.

Diagnostic Criteria (WHO 2016)

  • ≥20% blasts in the bone marrow or peripheral blood
  • Evidence of maturation – ≥10% of maturing cells of granulocytic lineage
  • Monocyte lineage <20% of bone marrow cells
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Blood Film Features:

  • Leucocytosis with myeloblast
  • Thrombocytopenia
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Bone Marrow Features:

  • Bone marrow is usually hypercellular
  • Myeloblast: commonly with auer rods and azurophilic granules
  • Monocyte lineage < 20% of bone marrow cells
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Blood film from a patient with acute myeloid leukaemia with maturation and a t(8;21) translocation. Note the presence of blasts with auer rods and maturing myeloid cells in the peripheral blood.

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Bone marrow aspirate from a patient with AML t(8;21). Note the numerous eosinophilic myelocytes. This is AML M2-Eo (M2 with eosinophilia). The blasts have a peri-nuclear hoff, basophilic cytoplasm and azurophilic granules, which is characteristic of AML t(8;21). The blasts are expected to be dimly positive for CD19 on flow cytometry.

Other features to look for:

  • Variable degrees of dysplasia
  • Increased basophils and mast cells
  • Eosinophil precursors – suggestive of M2Eo
  • Blasts with a perinuclear hof, abundant basophilic cytoplasm with azurophilic granules – suggestive of acute myeloid leukaemia with t(8;21)(q22;q22.1)

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By |2020-12-03T14:52:50+08:00February 23rd, 2020|0 Comments

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