John Libbey Eurotext

Hématologie

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Difficulties of classifying an acute myeloid leukemia occurring during hemolytic crisis Volume 24, issue 3, Mai-Juin 2018

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Authors
Service d’hématologie biologique, Hôpital Avicenne, APHP, Bobigny
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We report here a case of acute myeloid leukemia diagnosed during a haemolytic crisis following antimalarial-treatment with quinine, revealing a G6PD deficiency. A 74-year-old man, without medical history, showed a severe regenerative anemia, with a blood blastosis and an important erythroblastemia. Bone marrow examination found a limited percentage of blasts (10 %) because of a large erythroblastic hyperplasia. Cytogenetic analysis did not found any acquired abnormalities. In total, the retained diagnosis was acute myeloid leukemia not otherwise specified, according to the 2016 WHO classification, despite bone marrow blastosis of less than 20 % and preponderant erythroid component. This case highlights the difficulty of classifying an acute leukemia diagnosed concomitantly with hemolytic anemia.