AML-M0 (Acute Minimally Differentiated Leukemia )

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 AML-M0 blasts have been described as immature and agranular and frequently lack morphological features of a specific cell lineage, and were then categorized by strict cytochemical and phenotypic criteria. Undifferentiated blasts negative for myeloperoxydase. Positivity of at least one myeloid marker (CD13, CD33, CD65, CD117-c-KIT). Frequent expression of early progenitor markers CD34, DR; TdT in 30-40% of the cases; CD7 expression frequent in children. MPO antigen identified in about 50% of the cases.

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Immunphenotyping:

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Positive for CD13, CD33 , CD34, CD117, HLA-DR and CD38, Variable expression of myeloperoxidase, Sudan Black B, TdT (50%), CD2, CD4, CD7 (40%) and CD16/ CD56 and Negative for CD11b (usually), CD14 (usually), CD15 (usually), CD36 (usually), CD41, CD61, CD64 and most lymphocyte antigens(CD5, cCD3, cCD79a, cCD22), Glycophorin A

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EXAMPLE:

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Above case shows (blasts- red, lymp-green, grans-blue, monos-pink) positivity for CD33, HLA-DR  and negativity for CD34, MPO, CD117, cCD79a, CD13, CD7, CD65, CD15, CD64, CD14, CD19,

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Reference:

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• Barbaric, D., Alonzo, T.A., Gerbing, R.B., Meshinchi, S., Heerema, N.A., Barnard, D.R. et al. Minimally differentiated acute myeloid leukemia (FAB AML-M0) is associated with an adverse outcome in children: a report from the Children's Oncology Group, studies CCG-2891 and CCG-2961. Blood. 2007; 109: 2314–2321  PubMed

• Sempere, A., Jarque, I., Guinot, M., Palau, J., Garcia, R., Sanz, G.F. et al. Acute myeloblastic leukemia with minimal myeloid differentiation (FAB AML-M0): a study of eleven cases. Leuk Lymphoma. 1993; 12: 103–108| PubMed

• Cuneo, A., Ferrant, A., Michaux, J.L., Boogaerts, M., Demuynck, H., van Orschoven, A. et al. Cytogenetic profile of minimally differentiated (FAB M0) acute myeloid leukemia: correlation with clinicobiologic findings. Blood. 1995; 85: 3688–3694 PubMed

• Stasi, R., Del Poeta, G., Venditti, A., Masi, M., Stipa, E., Dentamaro, T. et al. Analysis of treatment failure in patients with minimally differentiated acute myeloid leukemia (AML-M0). Blood. 1994; 83: 1619–1625  PubMed

• Creutzig, U., Harbott, J., Sperling, C., Riter, J., Zimmermann, M., Löffler, H. et al. Clinical significance of surface antigen expression in children with acute myeloid leukemia: results of study AML-BFM-87. Blood. 1995; 86: 3097–3108 PubMed

• Huang, S.Y., Tang, J.L., Jou, S.T., Tsay, W., Hu, C.H., Lin, D.T. et al. Minimally differentiated acute myeloid leukemia in Taiwan: predominantly occurs in children less than 3 years and adults between 51 and 70 years. Leukemia. 1999; 13: 1506–1512 PubMed

• Venditti, A., Del Poeta, G., Buccisano, F., Tamburini, A., Cox, M.C., Stasi, R. et al. Minimally differentiated acute myeloid leukemia (AML-M0): comparison of 25 cases with other French-American-British subtypes. Blood. 1997; 89: 621–629 PubMed

• Kotylo, P.K., Seo, I.S., Smith, F.O., Heerema, N.A., Fineberg, N.S., Miller, K. et al. Flow cytometric immunophenotypic characterization of pediatric and adult minimally differentiated acute myeloid leukemia (AML-M0). Am J Clin Pathol. 2000; 113: 193–200 PubMed

• Cascavilla, N., Melillo, L., D’Arena, G., Greco, M.M., Carella, A.M., Sajeva, M.R. et al. Minimally differentiated acute myeloid leukemia (AML-M0): clinico-biological findings of 29 cases. Leuk Lymphoma. 2000; 37: 105–113 PubMed

• Acute myeloid leukaemia M0: haematological, immunophenotypic and cytogenetic characteristics and their prognostic significance: an analysis in 241 patients.Béné MC, Bernier M, Casasnovas RO, Castoldi G, Doekharan D, van der Holt B, Knapp W, Lemez P, Ludwig WD, Matutes E, Orfao A, Schoch C, Sperling C, van't Veer MB.British journal of haematology. 2001 ; 113 (3) : 737-745. PMID 11380465

• The immunophenotype of minimally differentiated acute myeloid leukemia (AML-M0): reduced immunogenicity and high frequency of CD34+/CD38- leukemic progenitors. Costello R, Mallet F, Chambost H, Sainty D, Arnoulet C, Gastaut JA, Olive D Leukemia : official journal of the Leukemia Society of America, Leukemia Research Fund, U.K. 1999 ; 13 (10) : 1513-1518. PMID 10516751

• AML-M0: a review of laboratory features and proposal of new diagnostic criteria. Stasi R, Amadori S. Blood cells, molecules & diseases. 1999 ; 25 (2) : 120-129.

• PMID 10389594