Re: Lee H, <i>et al.</i> An Unusual Case of Myeloperoxidase-Positive Acute Megakaryoblastic Leukemia. Ann Lab Med 2015;35:466-8
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Dear Editor The authors claim that they identified a patient with AML (subtype; acute megakaryocytic leukemia, AMKL) who presented with a peripheral blast count of 47% but an elevated platelet count of 519×109/L. The blasts were myeloperoxidase (MPO)+and contained Auer rods (not described in the literature). In Fig. 1 these cells displayed typical agranular blasts and a rare granular blast and easily recognized MPO+blasts. Nonspecific esterase was negative by butyrate staining (many megakaryocytes are strongly+using an alpha naphthyl acetae reaction). By flow cytometry the blasts were CD7, CD11c, CD13, CD33, CD117, cytoplasmic MPO, HLA-DR+ but negative for CD34 (which can be absent in myeloblasts). The only antigen detected for a megakaryocyte lineage was CD41a. The high platelet count could easily have produced a false+reaction with respect to the CD41 antibody by adhering to the myeloblasts. Cytospin immunofluorescence can differentiate platelet adhesion by showing punctu
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Dear Editor The authors claim that they identified a patient with AML (subtype; acute megakaryocytic leukemia, AMKL) who presented with a peripheral blast count of 47% but an elevated platelet count of 519×109/L. The blasts were myeloperoxidase (MPO)+and contained Auer rods (not described in the literature). In Fig. 1 these cells displayed typical agranular blasts and a rare granular blast and easily recognized MPO+blasts. Nonspecific esterase was negative by butyrate staining (many megakaryocytes are strongly+using an alpha naphthyl acetae reaction). By flow cytometry the blasts were CD7, CD11c, CD13, CD33, CD117, cytoplasmic MPO, HLA-DR+ but negative for CD34 (which can be absent in myeloblasts). The only antigen detected for a megakaryocyte lineage was CD41a. The high platelet count could easily have produced a false+reaction with respect to the CD41 antibody by adhering to the myeloblasts. Cytospin immunofluorescence can differentiate platelet adhesion by showing punctu
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