An Observational Analysis on Clinico-hematological profile of Acute Myeloid Leukemia: At a Tertiary care facility

Background: Acute myeloid leukemia{AML} is characterized by clonal neoplastic proliferation of myeloid precursor cells in the marrow arrest of their maturation. Its annual incidence is 2-3 per 10,000 and increases with age. In adults this accounts for 80-90% of cases. The morphology {by Bone marrow aspiration, bone marrow biopsy}, cytogenetics and molecular abnormalities {by Immunophenotyping} of leukemic cells are currently used to classify AML into various risk categories. Material and Methods: This is an observational study performed over a period of six months from September 2022 to February 2023 in the department of Pathology, PGIMS, Rohtak. Bone marrow trephine biopsy, Flow cytometry and cytogenetics were also used for correlation wherever possible. Results: Out of total 243 bone marrow aspirates, 27 cases were diagnosed as AML in different age groups, with youngest being in 4 years male child diagnosed as acute promyelocytic leukemia. Most common clinical presentation was fever, generalized weakness, petechiae, lymphadenopathy and hepatosplenomegaly. On the rare note, a 11 year old male presented with right orbital malignant mass. In some cases, further morphological subcategorization was done and correlated with IPT and/or cytogenetics. Conclusion: Bone marrow aspiration provides cytomorphological details and biopsy reveals the pattern of distribution of cells. IPT allows for the objective and reproducible distinction of AML, also these can be further classified into a number of different subtypes. Cytogenetics is the most important prognostic factor for predicting remission rate, relapse and overall survival. Thus, all these hematological profiles should be correlated in the diagnosis and further management.

Keywords: Acute myeloid leukemia, Cytogenetics, Acute lymphoblastic leukemia.