Myeloperoxidase Deficient Acute Promyelocytic Leukemia: Report of Two Cases

  • Pulkit Rastogi
  • Saniya Sharma
  • Sreejesh Sreedharanunni
  • Prashant Sharma
  • Man Updesh Singh Sachdeva
  • Richa Jain
  • Shano Naseem
  • Amit Trehan
  • Neelam Varma

Acute promyelocytic leukemia (APL) is characterized by the presence of ‘abnormal promyelocytes’ which show variable morphology but a characteristic strong myeloperoxidase (MPO) positivity on cytochemistry and immunohistochemistry (IHC). The characteristic morphology and cytochemistry is often considered as a strong evidence to make a morphological diagnosis of APL and often enough to prompt a haematologist to start all-trans-retinoic acid (ATRA), before a confirmatory molecular diagnosis arrives. We herein describe two cases of classical APL having an absent/reduced MPO activity.

Case 1

A 6-year-male child presents with history of ecchymosis and pallor. His complete blood count revealed pancytopenia (hemoglobin—82 gm/L, leukocyte count—4.1 × 10 9/L and platelet count—19 × 10 9/L). There were 40% abnormal promyelocytes in peripheral blood and 79% in bone marrow with occasional faggot cells. The findings were highly suspicious of APL, but the promyelocytes were negative for MPO on...


Compliance with Ethical Standards

Conflict of interest

All authors declare that they do not have any conflict of interest.

Ethical Statement

This article does not contain any studies with human participants or animals performed by any of the authors. The article does not include any identifying information of any individual.


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Copyright information

© Indian Society of Haematology & Transfusion Medicine 2017

Authors and Affiliations

  1. 1.Department of HematologyPostgraduate Institute of Medical Education and ResearchChandigarhIndia
  2. 2.Department of Pediatric Hematology/Oncology UnitPostgraduate Institute of Medical Education and ResearchChandigarhIndia

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