40/F presented to AIIMS OPD with the following findings-Hb-9.8gm%, TLC= 15,700/cumm, Platelet counts 3 lac/cumm. Peripheral smear showed increased neutrophils with 14 % blasts, 15% myelocytes and metamyelocytes with some dysplasia. Cytogenetic study revealed t(8;21). What is your diagnosis?

Ans. (a) AML(Ref: Robbins 9th/pg 612; 8th/pg 622)This 40 yr old female is presenting with leukocytosis and increased blast counts in the peripheral smear. The cytogenetic study done here shows t(8;21). This finding is suggestive of Acute myeloid leukemia even if there are <20% blast counts.It cytogenetic abnormalities like t(15;17),t(8;21), inv(16) are encountered in a patient with symptomatic myeloid disease, AML should be diagnosed despite the lower blast percent.