Acute Myeloblastic Leukemias

AMLs result from a neoplastic transformation of a single pluripotential hematopoietic stem cell. Evidence to support this statement is morphological,53 immunological,54 and chromo-somal55 as well as from in vitro cell culture studies. These studies have demonstrated trilineage dysplastic features or myeloid antigen expressions in AML, monocytic, and erythroid precursors in cultures, and elaboration of colony-stimulating factors (CSFs) from monocytes.

Four major types of AML have long been recognized: acute myeloid, acute myelomonocytic, acute monocytic, and acute erythroleukemia. Despite these subtype definitions, Auer rods are the only consistent neoplastic marker demonstrating that a blast is myeloid and of leukemic origin. Auer rods are abnormal azurophilic crystalline-like granules that represent the coalescence of primary lysosomal granules of myeloid precursors, as documented by cytochemical and ultrastructural studies.56,57

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