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01-05-2021 | Acute Myeloid Leukemia | Images in Hematology
Relapsed RUNX1-RUNX1T1-positive acute myeloid leukemia with pseudo-Chediak-Higashi granules
Published in: International Journal of Hematology | Issue 5/2021
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A 7-year-old boy was diagnosed with RUNX1-RUNX1T1-positive acute myeloid leukemia (AML). Leukemic blasts were morphologically typical of AML-M2, with MPO-positive granules and Auer rods (Fig. 1a). Some leukemic blasts had MPO-negative vacuoles (Fig. 1b). G-banding revealed a karyotype of 46, XY, t(8;21)(q22;q22). Fluorescence in situ hybridization (FISH) analysis revealed a RUNX1-RUNX1T1 fusion signal in 81% of analyzed cells. Molecular complete remission (CR) was achieved after one course of induction therapy, and the patient received six courses of chemotherapy in total.
Fig. 1
Bone marrow smears at initial diagnosis (a, b) and at relapse (c, d). a Wright-Giemsa stain shows leukemic blasts, and the right-most blast has an Auer rod (arrow). b Myeloperoxidase (MPO) staining shows that the blasts are MPO-positive, but the vacuole is MPO-negative (arrowhead). c The cytoplasm of leukemic blasts at relapse contain pink giant pseudo-Chediak-Higashi (PCH) granules (arrow). d PCH granules are MPO-positive (arrowhead)
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