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Acute basophilic leukemia

Acute basophilic leukemia is a rare form of acute myeloid leukemia where blasts are accompanied by abnormal basophils in all stages of differentiation. It would most likely be classified as M0 without electron microscopic confirmation of basophil lineage. Differentiated (basophilic granules by light microscopy) and poorly differentiated cases ; Majority are poorly differentiated. MPO negative by light microscopy; granules positive in a speckled pattern by electron microscopy. Myeloid antigens are expressed. Diagnosis of poorly differentiated cases made by electron microscopy. Cytogenetically heterogeneous but frequently associated with Philadelphia chromosome. There is no clinically distinguishing features but may be more common in children and young adults and carry a poor prognosis.


Positive for CD13 or CD33, CD123, CD203c, CD11b, CD34, CD9 usually, Some cases may be positive for CD22 or TdT, Most characteristic cytochemical reaction is metachromatic staining with toluidine blue, acid phosphatase (diffuse pattern), periodic acid Schiff (PAS) positivity in large blocks and Negative for Myeloperoxidase (MPO), Sudan Black B (SBB) or naphthol ASD chloroacetate esterase (CAE), CD117, tryptase, CD25, monocytic and lymphoid associated markers.


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                      Figure shows CD45+ population positive for CD33, CD117, CD9, HLA-DR, CD11b, CD13 while negative for CD10, CD25, CD123, CD34, CD15 and CD19.




























  Figure shows CD45+ population positive for CD9, CD203, CD36, CD117, CD33,  CD13, CD9, CD4 while negative for CD18, CD41, CD25, CD123, CD34, CD19, CD11b, CD3 and CD15.




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