APL - Slide 3

The images below come from a patient with an acute promyelocytic leukemia, complicated by bacteremia. A lot of promyelocytes have a slight bilobed nucleus, which is often reffered to as 'angel wings'. Some faggot cells are present. The APL is confirmed by molecular testing (t(15;17) translocation).

Blasts

Promyelocytes

Myelocytes

Neutrophils

Lymphocytes

Monocytes

Erythroblasts

Immunophenotype

CD34-

CD117+

HLA-DR-

CD13+

CD33++

CD56+

CD2-

Flowcytometry results from the bone marrow of the patient. The promyelocytes have a high side-scatter and are CD34-, CD117+ and HLA-DR-. The expression of CD13 is heterogenous and there is a strong, homogenous expression of CD33. The maturation marker CD15 is negative. Expression of CD56 is associated with a worse prognosis.

SSC

CD45

CD117

CD34

CD16

HLA-DR

CD13

CD15

CD33

CD64

CD56

CD34

Peripheral blood

Bone marrow

Angel Wings

Atypical promyelocytes