case_images: PMC11408469_01
case_images: Changes in trilineage count in patients from onset to complete remission.
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case_images: At the time of admission, blood tests showed hemoglobin, 59 g/L (reference range, 130-175 g/L); platelets, 26 x 109/L (reference range, 125-350 x 109/L); white blood cell count, 3.41 x 109/L (reference range, 3.5-9.5 x 109/L); prothrombin time, 15.9 s (reference range, 11-14.5 s); activated partial thromboplastin, 43.5 s (reference range, 28-45 s), fibrin degradation products (FDP) >150.00 ug/mL (reference range, < 5.00 ug/mL); fibrinogen, 3.56 g/L (reference range, 2.00-4.00 g/L); and D-dimer concentration > 20.0 ug/mL (reference range, < 5.00 ug/mL) ( Figure 1 ).
case_images: (A) Karyotype analysis shows 46, XY, t (11; 12) (p15; q13). (B) Morphology of bone marrow cells after IA and ATRA regimen. (C) Bone marrow morphology at complete remission after one cycle of azacitidine treatment (Wright-Giemsa-stained bone marrow smear, x1000). (D) Immunophenotypic analysis results of bone marrow cells at diagnosis. (E): Immunophenotypic analysis results of bone marrow cells at complete remission.
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case_images: BM cytomorphology still supported APL ( Figure 2B ). Karyotype analysis of the chromosomes was 46, XY, der (11) t (11;12) (p15;q13), -12, +mar [15] ( Figure 2A ). The leukemia cellular immunophenotype was positive for CD117, CD13, CD33, MPO, and CD45dim and negative for CD34, CD38, HLA-DR, CD11b, CD14, and other T- or B-lymphoid lineage markers ( Figure 2D ). In July, BM aspirate morphology confirmed complete remission (CR) with negative minimal residual disease through flow cytometry (FCM) ( Figures 2C, E ).
case_images: (A) PCR amplification curves of NUP98/RARG. (B) PCR amplification curves of ABL genes. Specific primers and probes were used for NUP98/RARG and ABL gene amplification.
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case_images: Paranasal sinus CT showing high density in the left nasal cavity.
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case_images: Subsequently, the patient underwent craniocerebral + paranasal sinus CT for headache, which showed abnormal high-density foci in the brain and high density in the left nasal cavity with possible secretion ( Figure 4 ).