FEATURES OF A DIFFERENTIAL DIAGNOSIS OF PEDIATRIC ACUTE MONOCYTIC LEUKEMIA (AML-M5a) ON THE EXAMPLE OF A CLINICAL CASE
https://doi.org/10.37748/2687-0533-2020-1-1-7
Abstract
The aim of this work was to assess the significance of investigating clinical and laboratory parameters for diagnosing acute monocytic leukemia in children on the basis of a clinical case. The article demonstrates specific features of differentiating AML M5a from other forms of acute myeloid leukemia. According to the results of hematological, morphological and cytofluorimetric studies of blood and bone marrow samples, the diagnosis of acute myeloid leukemia was established. The morphological and phenotypic characteristics of blast cells hampered the diagnosis of an AML form. However, a comprehensive analysis of the expressed CD antigens allowed acute monocytic leukemia to be identified, which diagnosis was subsequently confirmed by a cytochemical study. Thus, the clinical diagnosis was established over a short period of time. This was of importance given the rising severity of the patient’s condition requiring immediate treatment, the initial hyperleukocytosis and the development of life-threatening complications associated with leukostasis in the lungs and the central nervous system. In the presented case, the clinical manifestations of the underlying disease and the results of flow cytofluorimetry were determining factors in initiating timely specific therapy.
About the Authors
O. I. KitRussian Federation
Oleg I. Kit — RAS Corresponding Member, Dr. Sci. (Med.), Prof., General Director
63 14 line, Rostov-on-Don 344037
SPIN: 1728-0329
Scopus Author ID: 55994103100
N. K. Guskova
Russian Federation
Nailya K. Guskova — Cand. Sci. (Biol.), Head of the Clinical and Diagnostic Laboratory
63 14 line, Rostov-on-Don 344037
SPIN: 5407-6285
O. N. Selyutina
Russian Federation
Olesya N. Selyutina — Clinical Laboratory Specialist, Clinical Diagnostic Laboratory
63 14 line, Rostov-on-Don 344037
SPIN: 4347-0302
V. V. Dmitrieva
Russian Federation
Victoriya V. Dmitrieva — Pediatric Oncologist, Department of Pediatric Oncology
63 14 line, Rostov-on-Don 344037
SPIN: 4416-7947
I. A. Novikova
Russian Federation
Inna A. Novikova — Cand. Sci. (Med.), Deputy Director for Research
63 14 line, Rostov-on-Don 344037
SPIN: 4810-2424
I. S. Torpujyan
Russian Federation
Isabela S. Torpujyan — Pathologist, Clinical Diagnostic Laboratory
63 14 line, Rostov-on-Don 344037
V. R. Zakharchenko
Russian Federation
Victoriya R. Zakharchenko — Clinical Laboratory Specialist, Clinical Diagnostic Laboratory
63 14 line, Rostov-on-Don 344037
References
1. Nikitin V.Yu., Sukhina I. A., Kolyubaeva S. N., Ivanov A. M., Tsygan V. N., Zyuzgin I. S., et al. Immunophenotypic and cytogenetic characteristics of M4 and M5 variants of acute myeloid leukemia. Bulletin of the Military Medical Academy. 2009;4(28):121–130 (In Russian).
2. Hoffbrand V., Pettit J. Atlas guide. Hematology. Translated from the English. N. A. Timonina. Moscow: Praktika; 2007. 406 p. (In Russian).
3. Clinical Oncohematology: A Guide for Physicians Ed. M. A. Volkova. 2nd ed., Revised. and add. Moscow: Medicine; 2007. 1120 p. (In Russian).
4. Lugovskaya S. A., Pochtar M. E. Hematological atlas. 4th edition, optional. Moscow: LLC Publishing House Triada; 2016. 443 p. (In Russian).
5. Barovskaya Yu. A. Diagnosis and treatment of acute myeloid leukemia in children: Modern aspects. Pediatric Hematology Oncology and Immunopathology. 2015;14(3):48–54 (In Russian).
6. Nagornaya N. V., Vilchevskaya E. V., Marchenko E. N., Bordyugova E. V., Dudchak A. P., Dubovaya A. V., et al. Analysis of the causes of late diagnosis of acute leukemia in children. Child Health. 2012;1 (36):84–89 (In Russian).
7. Kaznatcheev K. S. Complicated questions of early diagnostics of acute leukemia at children. Vestnik NSU. Series: Biology and clinical medicine. 2011;9(2):211–214 (In Russian).
8. Arber D. A., Orazi A., Hasserjian R., Thiele J., Borowitz M. J., Le Beau M. M., et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 2016;127(20):2391–2405. http://doi.org/10.1182/blood-2016–06–721662
Review
For citations:
Kit O.I., Guskova N.K., Selyutina O.N., Dmitrieva V.V., Novikova I.A., Torpujyan I.S., Zakharchenko V.R. FEATURES OF A DIFFERENTIAL DIAGNOSIS OF PEDIATRIC ACUTE MONOCYTIC LEUKEMIA (AML-M5a) ON THE EXAMPLE OF A CLINICAL CASE. South Russian Journal of Cancer. 2020;1(1):76-83. (In Russ.) https://doi.org/10.37748/2687-0533-2020-1-1-7