The morphologic appearance of the bone marrow in a patient with acute promyelocytic leukemia (APML) may be very similar to that of a patient with benign myeloid proliferation in the recovery phase following acute agranulocytosis. The staining pattern of promyelocytes to CD117 and CD11b can help distinguish between these 2 conditions. The authors are from the University of Sao Paulo in Brazil.
The bone marrow in both conditions shows the presence of myeloid proliferation (increased M:E ratio) with marked increase in promyelocytes.
Immunostain |
Agranulocytosis |
APML |
CD117 positive |
0 out of 5 patients |
24 of 31 patients |
CD11b positive |
5 out of 5 patients |
2 of 31 patients |
data from Table 3
If the data in Table 3 is analyzed, the following immunophenotypic frequencies are seen:
Immunophenotype |
Agranulocytosis |
APML |
CD117(+), CD11b(-) |
0 of 5 |
23 of 31 |
CD117(+), CD11b(+) |
0 of 5 |
1 of 31 |
CD117(-), CD11b(-) |
0 of 5 |
6 of 31 |
CD117(-), CD11b(+) |
5 of 5 |
1 of 31 |
Immunophenotype |
Interpretation |
CD117(+), CD11b(-) |
APML |
CD117(+), CD11b(+) |
possibly APML |
CD117(-), CD11b(-) |
probably APML |
CD117(-), CD11b(+) |
probably agranulocytosis |
Specialty: Hematology Oncology
ICD-10: ,