AML with maturation (AML-M2)

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AML with maturation (AML-M2) is defined as an acute leukemia with ≥20% blast cells in the bone marrow and/or peripheral blood and evidence of granulocytic maturation. The maturing non-blast granulocytic cells account for ≥10% and monocytic cells ≤20% of the bone marrow cells. The myeloid origin of blast cells is confirmed by positive (≥3%) staining for MPO and/or Sudan Black B, as well as expression of myeloid-associated markers by immunophenotypic studies.

Blasts commonly show cytoplasmic granules, and Auer rods are often seen. Cytochemistry and immunophenotype show typical myeloid reactivity and antigen expression, including more mature markers such as CD11b, CD15 or CD65, usually without expression of monocytic markers CD14 and CD64.

Immunophenptyping shows expression of MPO, expression of one or more other myeloid-associated antigens (CD11b, CD13, CD15, CD33, and CD65), variable expression of CD34 and/or CD117, variable presence of cross-lineage aberrancies. Cytogenetic abnormalities include t(2;9)(q14;p12), t(5;11)(q35;q13) (Figure 21.8), t(10;11)(p13;q14), t(8;19)(q22;q13), t(8;16)(p11.2;p13), del(12)(p11–p13), and various complex translocations.

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Immunophenotype:

Positive for CD7 (20 - 30%), CD11b, CD13, CD15, CD33, often CD34, HLA-DR, CD65, CD71 (variable), CD99 and CD117, Uncommon CD2, CD4, CD19 and CD56 (approx 10%)Negative for CD14, CD36, CD41, CD61, CD64 and glycophorin A

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Reference:

• http://www.pathologyoutlines.com/topic/leukemiaM2.html

• http://wiki.clinicalflow.com/aml-acute-myelogenous-leukemia-maturation-m2

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• Bennett, J.H. (1852). Leucocythemia or White Cell Blood, pp 7–82. Edinburgh.

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• Chi Y, Lindgren V, Quigley S, Gaitonde S (2008). "Acute Myelogenous Leukemia With t(6;9)(p23;q34) and Marrow Basophilia: An Overview". Arch Pathol Lab Med. 132: 1835–7.

• Cullen, P. (1811) Case of splenitis acutus in which the serum of the blood drawn from the arm had the appearance of milk. Edinburgh Medical Journal, 169–171.

• Dohner H, Estey E, Amadori S, Appelbaum F, Buchner T, Burnett A, et al. (2009). "Diagnosis and management of acute myeloid leukemia in adults: recommendations from an international expert panel, on behalf of the European LeukemiaNet". Blood. 115 (3): 453–474. doi:10.1182/blood-2009-07-235358. PMID 19880497.

• Elagib K. and Goldfarb A. (2006). Oncogenic pathways of AML1-ETO in acute myeloid leukemia: multifaceted manipulation of marrow maturation. Cancer Lett. doi:10.1016/j.canlet.2006.10.010.

• Faderl S, Kantarjian HM, Estey E, Manshouri T, Chan CY, Rahman Elsaied A, et al. (2000). "The prognostic significance of p16(INK4a)/p14(ARF) locus deletion and MDM-2 protein expression in adult acute myelogenous leukemia". Cancer. 89: 1976–1982. doi:10.1002/1097-0142(20001101)89:9<1976::aid-cncr14>3.3.co;2-e.

• Falini B, Tiacci E, Martelli MP, Ascani S, Pileri SA (2010). "New classification of acute myeloid leukemia and precursor-related neoplasms: changes and unsolved issues". Discov Med. 10 (53): 281–92.