Acute Myeloblastic Leukemia With Significant Maturation M2

The defining characteristic that separates M2 from M1 is clear evidence of significant differentiation in all cells beyond the promyelocyte stage (Plate 14-11). The sum of the blast cells (type I + type II +, and type III) is greater than 30 percent but less than 90 percent, and generally there is a large predominance of type II blasts. Monocytic precursors cannot exceed 20 percent. Increased numbers of eosinophilic precursors (M2Eo) as well as pseudo-Pelger-Huet cells and hypogranular neutrophils may be seen. The MPO and SBB reactions are strongly positive. However, M2 cases with a partial MPO deficiency in the granu-locytic precursors and mature granulocytes have been reported.81 M2 may be associated with basophilia and this rare form must be separated from CGL blast crisis.82 M2Eo should be separated from the more common M4Eo.

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