A rare case of acute basophilic leukemia

Abstract

Acute basophilic leukemia is an extremely rare form of acute myeloid leukemia and diagnosis is based on morphological, cytochemical and ultrastructural analyses of basophils and blastic cells. It is usually characterized by a very rapid clinical course, symptoms of hyperhistaminemia and resistance to therapy. A 73 year-old male presented with itching, thrombocytopenia and leukocytosis. There was no hepatosplenomegaly. In the flow cytometry evaluation of peripheral blood, CD123 positive myeloid blasts were detected at the rate of 60%. Also, CD13 and CD33 were positive, while CD34, CD117, HLA DR and myeloperoxidase (MPO) were negative. These findings were considered as consistent with ABL. Following, the diagnosis of ABL was confirmed by bone marrow evaluation including cytomorphological and immunohistochemical studies. On the other hand, cytogenetical analyses of bone marrow showed the presence of the Philadelphia chromosome.The patient received one cycle of a chemotherapy regimen including cytarabine and idarubicin with imatinib support, but he died on the 10th hospital day. Considering that ABL behaves in a very malignant fashion, and a more aggressive treatment approach is necessary for patients with this specific subtype of AML.