A 15-year-old boy presented with one day history of bleeding gums, subconjunctival bleed and purpuric rash. Investigations revealed the following results: Hb-6.4 gm/dL; TLC-26,500/mm3 Platelet 35,000 mm3; prothrombin time-20 sec with a control of 13 sec; paial thromboplastin time-50 sec; and Fibrinogen 10mg/dL. Peripheral smear was suggestive of acute myeloblastic leukemia. Which of the following is the most likely?
The child presented with acute onset of bleeding, along with the following laboratory findings: Thrombocytopenia (35000/mm3 as compared to normal value of 1, 50,000/mm3) Increased prothrombin time (20s as compared to control of 13s) Increased paial thromboplastin time (50s vs. normal 26-32s) Decreased fibrinogen (10 mg/dL vs. normal of 233- 496 mg/dl) These hematological abnormalities indicate disseminated intravascular coagulation. Most common form of AML associated with DIC is M3-AML (Acute promyelocytic leukemia). All-trans retinoic acid (ATRA), an analogue of vitamin A induce the neoplastic promyelocytes to differentiate into neutrophils rapidly and decrease chance of DIC. other agent useful is AsO3(arsenic trioxide).
Myeloblastic leukemia without maturation
Myeloblastic leukemia with maturation
Promyelocytic leukemia
Myelomonocytic leukemia
Acute Myelogenous Leukemia