Original article / research
Clinico-Haematological and Cytochemical Study of Acute Myeloid Leukaemia
Dr. Reetesh Kumar Gujar,
E-303, Government Medical College Campus, Ratlam, Madhya Pradesh, India.
Introduction: Acute Myeloid Leukaemia (AML) presents one of the common problems in the field of haematology affecting primarily adults, peaking incidence between the ages of 15-39 years. Incidence and patterns of AML vary in different parts of the world. The most commonly used classification was proposed by the French American British (FAB) co-operative group in 1976.
Aim: To study the clinical features and presentation of patients of AML and to categorise those into different subtypes based on their haematological and cytochemical features using various cytochemical stains.
Materials and Methods: All the patients diagnosed as AML in the Department of Pathology, Gajra Raja Medical College and Jayarogya group of Hospital, Gwalior from 1st December 2012 to 30th November 2013 were enrolled in this descriptive cross-sectional study. Clinical histories of all cases were retrieved subsequently and complete blood count with detailed peripheral smear and bone marrow smear examination was done. AML subtyping was done based on FAB Criteria. Cytochemical stains like Periodic Acid Schiff Stain (PAS), Non Specific Esterase (NSE) stain, Myelo-Peroxidase (MPO) stain and Sudan Black B (SBB) stain were used. MPO stain and SBB stain shows positivity in myeloid series of cells and NSE stain shows positivity in monocytic cells whereas PAS stain shows negative staining in myeloid cells.
Results: AML M2 was more prevalent than other subtypes constituting 69.44% of all cases (25 out of 36 cases), followed by AML M1 constituting 16.66% (6 out of 36 cases). All types of AML were more commonly seen in males than females, ratio being 2:1. Majority of patients of AML presented with pallor, fever, leucocytosis and thrombocytopenia.
Conclusion: Microscopic examination of peripheral blood and bone marrow along with cytochemical staining remains foundation in the diagnosis as well as subtyping of acute Leukaemia, especially in the areas where immunophenotyping and flowcytometry are not readily available.
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