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Acute de novo basophilic leukemia (the patient was treated with CR with vincristine-prednisolone and simultaneous H2-receptor antagonists)
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A 71 year old man presented with a 1-year history of fatigue,
weakness, recurrent cutaneous plaques and severe bone pain mainly
along the spine (lumbar region and shoulders bilaterally). Physical
examination revealed pallor, mild hepatosplenomegaly, multiple
small lymph nodes and cutaneous plaques (violaceous, raised, non
tender) on the skin of the arms, legs and back. Multiple gastric
ulcers were detected by gastroscopy. Blood examination: anemia,
normal leukocyte count, neutrophils 43%, lymphocytes 36%, basophils
1%, monocytes 1%, blasts 19% (some containing large granules)
and erythroblasts 8/100 cells. The bone marrow aspiration was
dry trap but smears obtained from biopsy material showed infiltration
of blasts (MPO, PAS, NSE negative) expressing CD33 (36%), CD13
(211%) and CD15 (18%). The cytogenetic and molecular study for
Ph1 and bcr/abl were negative.
