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Acute basophilic leukemia presenting with maculopapular rashes and a gastric ulcer: A case report.

Luo XH, Zhu Y, Tang XQ - Oncol Lett (2014)

Bottom Line: The patient initially demonstrated clinical improvement as a result of chemotherapy, however, subsequently deteriorated.The gastric and skin manifestations of ABL may be associated with excessive histamine release from basophilic cells.Thus, the administration of H1- and H2-receptor antagonists, proton pump inhibitors and steroids is proposed in order to minimize these associated complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China.

ABSTRACT
Acute basophilic leukemia (ABL) is a rare and poorly characterized form of leukemia. The case of a 65-year-old male who complained of dizziness, maculopapular skin lesions and melena is described in the current report. A gastroscopy was conducted and indicated a gastric antral ulcer. The diagnosis of ABL was determined due to characteristic cytomorphological features, the myeloid immunophenotype of the blast cells (identified to be positive for cluster of differentiation [CD]25 and CD123) in addition to the absence of the Philadelphia chromosome and a c-kit D816V mutation. The patient initially demonstrated clinical improvement as a result of chemotherapy, however, subsequently deteriorated. The gastric and skin manifestations of ABL may be associated with excessive histamine release from basophilic cells. Thus, the administration of H1- and H2-receptor antagonists, proton pump inhibitors and steroids is proposed in order to minimize these associated complications.

No MeSH data available.


Related in: MedlinePlus

(A) Bone marrow aspirate demonstrating acute basophilic leukemia blast cells (magnification, ×100). (B) Certain blast cells demonstrated basophilic granulations. (Stain, Wright-Giemsa; magnification, ×1000).
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f3-ol-08-06-2513: (A) Bone marrow aspirate demonstrating acute basophilic leukemia blast cells (magnification, ×100). (B) Certain blast cells demonstrated basophilic granulations. (Stain, Wright-Giemsa; magnification, ×1000).

Mentions: The results of a bone marrow aspirate (stain, Wright-Giemsa) were as follows: Blast cells, 13%; atypical immature basophils, 14%; mature basophils, 8%; normal mature neutrophils, 11%; and erythroid cells, 13%. The blast cells contained basophilic granules, and the vacuoles in the cytoplasm and nuclei were oval and bilobed and contained nucleoli (Fig. 3A and B). The blast cells were positive for peroxidase and periodic acid-Schiff staining (PAS) and negative for α-naphthyl acetate esterase. The blast cells exhibited metachromasia as a result of staining with toluidine blue. Six days later, the bone marrow aspirate with Wright-Giemsa stain was conducted again, and showed 13% blast cells, 16% atypical immature basophils and 8% mature basophils, with 9% normal mature neutrophils. Cytogenetic studies using GTG banding revealed an abnormal karyotype, 44 XY,add(3)(p26),-5,-11,add(14)(q32),+mar1, +mar2,inc[18]/46,XY[2] (Fig. 4). Flow cytometric analysis of the blast cells was positive for cluster of differentiation (CD)11b, CD13, CD22, CD25, CD33 and CD123 (Fig. 5). BCR-ABL fusion was identified to be negative by reverse transcription-polymerase chain reaction analysis and no c-kit D816V mutation was detected.


Acute basophilic leukemia presenting with maculopapular rashes and a gastric ulcer: A case report.

Luo XH, Zhu Y, Tang XQ - Oncol Lett (2014)

(A) Bone marrow aspirate demonstrating acute basophilic leukemia blast cells (magnification, ×100). (B) Certain blast cells demonstrated basophilic granulations. (Stain, Wright-Giemsa; magnification, ×1000).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4214495&req=5

f3-ol-08-06-2513: (A) Bone marrow aspirate demonstrating acute basophilic leukemia blast cells (magnification, ×100). (B) Certain blast cells demonstrated basophilic granulations. (Stain, Wright-Giemsa; magnification, ×1000).
Mentions: The results of a bone marrow aspirate (stain, Wright-Giemsa) were as follows: Blast cells, 13%; atypical immature basophils, 14%; mature basophils, 8%; normal mature neutrophils, 11%; and erythroid cells, 13%. The blast cells contained basophilic granules, and the vacuoles in the cytoplasm and nuclei were oval and bilobed and contained nucleoli (Fig. 3A and B). The blast cells were positive for peroxidase and periodic acid-Schiff staining (PAS) and negative for α-naphthyl acetate esterase. The blast cells exhibited metachromasia as a result of staining with toluidine blue. Six days later, the bone marrow aspirate with Wright-Giemsa stain was conducted again, and showed 13% blast cells, 16% atypical immature basophils and 8% mature basophils, with 9% normal mature neutrophils. Cytogenetic studies using GTG banding revealed an abnormal karyotype, 44 XY,add(3)(p26),-5,-11,add(14)(q32),+mar1, +mar2,inc[18]/46,XY[2] (Fig. 4). Flow cytometric analysis of the blast cells was positive for cluster of differentiation (CD)11b, CD13, CD22, CD25, CD33 and CD123 (Fig. 5). BCR-ABL fusion was identified to be negative by reverse transcription-polymerase chain reaction analysis and no c-kit D816V mutation was detected.

Bottom Line: The patient initially demonstrated clinical improvement as a result of chemotherapy, however, subsequently deteriorated.The gastric and skin manifestations of ABL may be associated with excessive histamine release from basophilic cells.Thus, the administration of H1- and H2-receptor antagonists, proton pump inhibitors and steroids is proposed in order to minimize these associated complications.

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China.

ABSTRACT
Acute basophilic leukemia (ABL) is a rare and poorly characterized form of leukemia. The case of a 65-year-old male who complained of dizziness, maculopapular skin lesions and melena is described in the current report. A gastroscopy was conducted and indicated a gastric antral ulcer. The diagnosis of ABL was determined due to characteristic cytomorphological features, the myeloid immunophenotype of the blast cells (identified to be positive for cluster of differentiation [CD]25 and CD123) in addition to the absence of the Philadelphia chromosome and a c-kit D816V mutation. The patient initially demonstrated clinical improvement as a result of chemotherapy, however, subsequently deteriorated. The gastric and skin manifestations of ABL may be associated with excessive histamine release from basophilic cells. Thus, the administration of H1- and H2-receptor antagonists, proton pump inhibitors and steroids is proposed in order to minimize these associated complications.

No MeSH data available.


Related in: MedlinePlus