Distinguishing Acute Promyelocytic Leukemia (APML) from the Recovery Phase of Acute Agranulocytosis Using CD117 and CD11b Immunostaining of the Bone Marrow
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
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