Acute myeloid leukemia with monocytic differentiation

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Acute myeloid leukemia with monocytic differentiation

#00066309

Author: Sumitha Baskaran; Madhura Jogwar; Metropolis healthcare limited
Category: Myeloid Neoplasms and acute leukemia (WHO 2016) > Acute Myeloid Leukemia > AML not otherwise specified > Acute monoblastic/monocytic leukemia
Published Date: 04/16/2026

Peripheral blood smear (Leishman stain,×400 and ×1000 oil immersion) showing marked leukocytosis with numerous circulating blasts and promonocytes exhibiting high nuclear–cytoplasmic ratio and immature chromatin. Red blood cells show anisopoikilocytosis with hypochromia. In a 74-year-old female, peripheral blood revealed 40% blasts and 48% promonocytes/monocytes. Flow cytometry demonstrated CD34 and HLA-DR positivity with expression of myeloid (CD13, CD33, CD117, cMPO) and monocytic (CD64, CD11c) markers, and was diagnostic of acute myeloid leukemia (AML) with monocytic differentiation. FISH analysis was negative for AML1-ETO [t(8;21)], PML-RARA [t(15;17)], CBFB [inv(16)], and MLL [11q23] rearrangements. Next-generation sequencing identified pathogenic variants in IDH1 (p.Arg132Ser), NRAS (p.Gly12Asp), and DNMT3A (p.Gly796Val), with no RNA fusion detected.

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