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Case Studies | Pathology | India | Volume 13 Issue 2, February 2024

An Unusual Case Report - An Adult of Chronic Myeloid Leukemia Presenting as Acute Myeloid Leukemia M7 (Megakaryocytic Blast Crisis)

Dr. Swati R. | Dr. Gayathri T. | Dr. Kavya N. | Dr. Prathima S.

Abstract: Acute Megakaryoblastic Leukaemia (AML, M7) is a rare type of acute myeloid leukemia (AML) evolving from primitive megakaryoblasts. It accounted for 1.2% of newly diagnosed AML according to Eastern Cooperative Oncology Group (ECOG) trials between 1984 and 1997 [1]. It is an uncommon form of AML accounting for 8 - 10% of all AML cases in adults, and 2 - 3% of cases in children. crisis in CML since it occurs in nearly 20% of Ph positive CML cases [2]. Chronic myeloid leukaemia (CML) presenting primarily as megakaryocytic blast crisis is very rare, with very few case reports published to date [3] In adults, median age 57 years, 59% have prior hematologic disorder or myelodysplastic syndrome [4]. Associated with marrow fibrosis due to megakaryoblast secretion of fibrogenic cytokines, which makes marrow aspiration difficult [5]. Chronic myelogenous leukemia (CML) is a chronic myeloproliferative neoplasm consistently associated with the BCR - ABL1 fusion gene located in the Philadelphia chromosome. The Blast Phase is diagnosed when blasts are ?20% of the peripheral blood white cell count or of bone marrow nucleated cells or when there is an extramedullary blast proliferation. Megakaryocytic blast crisis as the presenting manifestation of CML is extremely rare [6]. This case report describes a 29 - year - old woman who presented with admitted with complaints of menorrhagia and abdominal distention (Massive splenomegaly). She was diagnosed with the case of AML based on peripheral blood and bone marrow showing features of AML. Chromosomal analysis revealed t (9: 22) (q34; q11.2) in all 40 metaphase analysed and immunophenotyping of peripheral blood with positivity for CD 45, CD41 (84%). CD41 and CD61 are megakaryocyte specific antigens, and CD45 expressed in blast window

Keywords: acute myeloid leukemia, acute megakaryocytic leukaemia, immunophenotyping, myelosclerosis chronic myeloid leukaemia, blastic crisis.

Edition: Volume 13 Issue 2, February 2024,

Pages: 281 - 284