Acute Myeloid Leukemia: FLT3/NPM1

摘要: A 74-year-old male was found to have pancytopenia with low vitamin B12 levels on routine physical exam his primary care physician. He complained of increasing fatigue over the last several months, which he attributed advancing age, but otherwise felt well. The patient denied any other symptoms. Pertinent family history revealed that father died acute leukemia at age 66 and mother 78 heart complications possible chronic lymphocytic leukemia. His physician attempted treat him in an effort address levels, there no response. For additional assessment pancytopenia, referred a hematologist who ordered laboratory studies evaluate peripheral blood bone marrow. complete count (CBC) showed megaloblastic anemia, critically white cell count, thrombocytopenia. Upon review smear, pathologist noted moderate anisopoikilocytosis red cells rare circulating blasts. On aspirate increase blasts identified comprising approximately 30% total nucleated cells. Erythroid precursors were markedly decreased. core biopsy marrow correlated these findings decreased cellularity 10%. patchy interstitial noted, 20% Megakaryocytes also Flow cytometric analysis distinct population cells, sample expressed CD13, CD33 (low density), CD34, CD38, CD117, HLA-DR, CD 45 density).