A 57-year-old woman was diagnosed with acute promyelocytic leukemia (APL) involving 40% of her bone marrow confirmed by PML-RARA quantitative PCR. She was started on induction therapy but developed treatment-related long QTc syndrome. Her regimen was reduced, and soon after, a follow-up bone marrow biopsy was performed. The bone marrow aspirate showed no morphologic features of residual acute leukemia but did reveal markedly bizarre erythroid atypia not seen in her earlier bone marrow specimen (see images).
Justin Juskewitch, M.D., Ph.D.
Resident, Division of Anatomic and Clinical Pathology
Min Shi, M.D., Ph.D.
Consultant, Division of Hematopathology
Assistant Professor of Laboratory Medicine and Pathology,
Mayo Clinic College of Medicine