Erythrophagocytosis associated with AML‐M5 and t(8;16)

Abstract

A woman presented with bruises, gum bleeding and thrombocytopenia. Overt disseminated intravascular coagulation (DIC) and spontaneous tumour lysis were also present. Bone marrow aspirate showed acute monoblastic leukaemia with florid erythrophagocytosis by the monoblasts (top left and right, bone marrow aspirate ×100). The blasts were strongly non-specific-esterase positive (bottom left ×100). Cytogenetics confirmed the presence of t(8;16)(p11;p13) (bottom right). Despite induction chemotherapy, low-dose heparin, and intensive blood product support, the patient's DIC remained refractory and was complicated by pulmonary haemorrhage. A d-18 marrow post-induction showed refractory disease, and the patient succumbed on d 19. The t(8;16) that results in fusion of the MOZ and CBP genes is uncommon in acute myeloid leukaemia (AML) but is classically associated with monoblastic morphology with erythrophagocytosis, DIC, extramedullary infiltration and a very poor prognosis.