title: Tetraploid acute promyelocytic leukemia with large bizarre blast cell morphology.
abstract: We describe a case of atypical acute promyelocytic leukemia (APL) with a tetraploid clone and multiple karyotypic abnormalities in addition to the translocation (15;17)(q22;q21). Microscopically, the leukemic cells were highly heterogeneous in morphology and granularity, being bizarre and large in size compared with classical APL blasts. The patient responded to treatment with chemotherapy and all-trans-retinoic acid, at diagnosis and at relapse 10 months later. He is currently in clinical and molecular remission, 3 years after initial diagnosis. Tetraploidy in association with large and bizarre blasts has not been previously reported in APL. Although tetraploidy and complex karyotypic aberrations confer a poor prognosis in other types of acute myeloid leukemia, in the presence of t(15;17) they did not appear to affect the prognosis, inasmuch as the clinical features and treatment outcome in our case followed those of APL in general.
authors.affiliation: Department of Medicine, University of Hong Kong, Queen Mary Hospital, People's Republic of China.
authors.forename: W Y
authors.initials: WY
authors.lastname: Au
authors.forename: S K
authors.initials: SK
authors.lastname: Ma
authors.forename: C C
authors.initials: CC
authors.lastname: Lam
authors.forename: L C
authors.initials: LC
authors.lastname: Chan
authors.forename: Y L
authors.initials: YL
authors.lastname: Kwong
mesh_terms: D000328:Adult; D000782:Aneuploidy; D001854:Bone Marrow Cells / Q000473:pathology*; D002884:Chromosomes, Human, Pair 15; D002886:Chromosomes, Human, Pair 17; D006801:Humans; D007621:Karyotyping; D015473:Leukemia, Promyelocytic, Acute / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D008297:Male; D014178:Translocation, Genetic