Acute monoblastic and acute monocytic leukemia (AML- M5)

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Acute monoblastic leukemia (AML-M5), is one of the most common subtypes of acute myeloid leukemia  that is either comprised of more than 80% of monoblasts (AML-M5a) or 30-80% monoblasts with (pro)monocytic differentiation (AML-M5b).

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Immunophenotype:

At least two monocytic markers (CD4, CD14, CD11b, CD11c , CD36, CD64, CD68 and HLA-DR), Myeloid markers:( CD13 , CD33 , CD15 and CD65) and Abberant expression (CD7, CD56 (25 - 40%), Lysozyme, CD68 and CD163) with CD34 (30%), CD117 and MPO (more often M5b and less often M5a).

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Example:

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Above case shows (lymp-green, grans-blue, monoblast-red) positivity for CD33, CD15dim, CD65, CD11b, CD64, CD9dim, CD4, CD56, CD36dim  and negativity for CD7, CD19, HLA-DR ,CD15,CD117, CD13,  cCD79a, cCD3, CD2

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References

• http://www.cancer.gov/types/leukemia/hp/adult-aml-treatment-pdq

• http://jco.ascopubs.org/content/22/7/1276.full.pdf

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

• https://www.orpha.net/data/patho/GB/uk-AMLM5.pdf

• http://www.ncbi.nlm.nih.gov/pubmed/14970186

• Vardiman JW, Thiele J, Arber DA, Brunning RD, Borowitz MJ, Porwit A, et al. The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: Rationale and important changes. Blood 2009;114:937-51.    

• Mitelman Database of Chromosome Aberrations and Gene Fusions in Cancer (2015). Mitelman F, Johansson B, Mertens F (Eds.), http://cgap.nci.nih.gov/Chromosomes/Mitelman. [Last accessed on 2015 Feb 01]. 

• Brunning RD, Matutes E, Flandrin D, Vardiman J, Bennett J, Head D. Acute myeloid leukaemia not otherwise categorised. In: Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al., editors. Pathology and Genetics of Tumours of Haematopoietic and Lymphoid Tissues. 4 th ed. Lyon: IARC Press; 2008.