# Case report: One case of acute myeloid leukemia M3 with atypical morphology

## TL;DR

A 35-year-old woman with atypical acute myeloid leukemia M3 achieved complete remission after treatment with retinoic acid, arsenous acid, and idarubicin.

## Contribution

This case report highlights the successful diagnosis and treatment of APL with atypical morphology using a combination of diagnostic and therapeutic approaches.

## Key findings

- The patient achieved complete remission after double induction therapy with retinoic acid and arsenous acid.
- Fusion gene analysis and flow cytometry were crucial for confirming the diagnosis of AML-M3 with atypical morphology.
- Blood routine tests and myelogram results normalized by the fifth week of treatment.

## Abstract

Acute promyelocytic leukemia (APL) is a type of acute myeloid leukemia. About 2% of APL is characterized by atypical rearrangements. Here we reported one APL case with atypical manifestations and morphology. A 35-year-old woman patient, mainly due to fatigue, poor appetite for over 10 days and intermittent fever for 3 days. combined with the results of flow cytometry, fusion gene and chromosome, the patient was diagnosed as AML-M3 with atypical morphology. Double induction therapy with retinoic acid and arsenous acid was immediately administrated. Idarubicin was administrated on the 18th day. A re-examination was performed in the 5th week, both the blood routine test and myelogram showed normal results, and the fusion gene turned negative, indicating complete remission. When atypical morphology occurs, peripheral blood POX staining may be performed to check the abnormal cells. Flow cytometry, chromosome analysis, and fusion gene analysis are also required for further diagnosis.