Khalid Hassan, Hasan Abbas Zaheer*, Javed Hussain, Humaira Qazi, Nadeem Ikram**,
Lubna Naseem and Tahira Zafar***
Department of Pathology, Pakistan Institute of Medical Sciences
* Blood Transfusion Centre, Pakistan Institute of Medical Sciences
** Department of Pathology, Rawalpindi Medical College, Rawalpindi
*** Clinical Hematologist, Children Hospital, Pakistan Institute of Medical Sciences
Background: Acute Promyelocytic Leukemia (AML-M3) patients, though amenable to treatment, present with early and sometimes severe bleeding manifestations. In our setup, for various reasons, patients are diagnosed rather late and therefore these bleeding manifestations are a limiting factor in the early and effective treatment of leukemia in such cases.
Objectives: To look into the clinical, peripheral blood and bone marrow features of AML-M3 patients in our setup.
Patients and Methods: A total of 40 consecutive cases of AML-M3 diagnosed on bone marrow biopsy over a period of 10 years were analyzed for clinico-morphological features.Results: Majority of patients (75%) were <30 years of age. The male: female ratio was 3:2. The mean duration of symptoms was 4.2 weeks (Range 1-10 weeks). Commonest clinical features were fever, pallor and bleeding manifestations. The spleen and liver were variably enlarged in 25% and 45.5% of cases, respectively. The hemoglobin levels ranged from 3.1 to 12.8 g/dl with a mean of 6.6 g/dl. The WBC count ranged from 0.5 to 142 x 109/l with a mean of 28.3 x 109/l. Platelet counts ranged from 5-150 x 109/l with a mean of 28.8 x 109/l. Morphologically 36 patients had hypergranular and 4 had hypogranular promyelocytic leukemia. Conclusion: The features identified in our study can help in early diagnosis of APL, which is known to be extremely important in effective management of patients. Key Words: Acute Promyelocytic Leukemia; AML-M3