Morphological subtyping of acute myeloid leukemia with maturation (AML-M2): homogeneous pink-colored cytoplasm of mature neutrophils is most characteristic of AML-M2 with t(8;21).
Morphologic and cytochemical features of 30 acute myeloid leukemia subtype M2 (AML-M2) patients with t(8;21) were compared with those of 50 AML-M2 patients without t(8;21). It was disclosed that irregular nuclear shape, Auer bodies, and at least 90% myeloperoxidase positivity in blast cells, and pseudo-Pelger-Huët anomaly of the nuclei and homogeneous pink-colored cytoplasm of mature neutrophils were observed in 90-100% of the t(8;21)+ patients. The percentages of patients showing these features were significantly (P < 0.01) lower in the t(8;21)- group. Among these morphological features, homogeneous pink-colored cytoplasm of mature neutrophils is most characteristic of t(8;21)+ AML-M2, because it was seen in 90% of the t(8;21)+ patients but in only 2% of the t(8;21)- patients. Conversely, pale-colored cytoplasm without any granules in mature neutrophils or dyserythropoietic features was observed in 84% of the t(8;21)- patients, but in none of the t(8;21)+ patients. These data suggest that it is possible to subtype AML-M2 patients morphologically by the recognition of homogeneous pink-colored or pale-colored cytoplasm of mature neutrophils and dyserythropoietic features. Thus, the morphologic subtyping of AML-M2 can be utilized alone or in combination with chromosomal or molecular subtyping for biological and clinical studies of AML with maturation.
Nakamura
H
H
Department of Hematology, Atomic Disease Institute, Nagasaki University School of Medicine, Japan.
Kuriyama
K
K
Sadamori
N
N
Mine
M
M
Itoyama
T
T
Sasagawa
I
I
Matsumoto
K
K
Tsuji
Y
Y
Asou
N
N
Kageyama
S I
SI
Sakamaki
H
H
Emi
N
N
Ohno
R
R
Tomonaga
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001853:Bone Marrow / Q000473:pathology; D002467:Cell Nucleus / Q000473:pathology; D002891:Chromosomes, Human, Pair 21; D002898:Chromosomes, Human, Pair 8; D003593:Cytoplasm / Q000473:pathology; D003594:Cytoplasmic Granules / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015479:Leukemia, Myelomonocytic, Acute / Q000097:blood / Q000145:classification* / Q000235:genetics* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology*; D014178:Translocation, Genetic