Acute Myelogenous Leukemia with Cuplike Nuclei

Based on the morphology of the blasts, it is difficult to determine cell lineage. [...]we performed immunophenotyping by flow cytometry on the peripheral blood specimen. A high correlation of cuplike nuclei and NPM1 mutation has been demonstrated by various studies.11-13 NPM1 mutations are further associated with a normal karyotype, an internal tandem duplication of the FLT3 gene, a higher white blood cell (WBC) count in the peripheral blood, a higher fraction of blasts in the bone marrow, lower expression of CD34 antigen, and female sex.4,9 Many of these characteristics are similar to our patient's leukemic expression.