Title-Hypoplastic Acute Myeloid Leukemia - Case Report with  Literature Review.

Abstract Introduction: Hypoplastic acute leukemia (HAL), also known as smoldering leukemia, is a form of atypical leukemia. It is a rare entity and currently defined as having cellularity of 20 % blasts at presentation. Hypocellular acute myeloid leukemia are more frequent than hypocellular variant of acute lymphoid leukemia. Although cases of hypoplastic acute myeloid in children and younger age group have been reported in literature, they are extremely rare. Case Presentation: A 16 year old boy presenting with fever, dyspnea, weakness and easy fatigueability. Bone marrow aspirate revealed hypocellular smears with presence of 38 % blasts. Immunohistochemistry was performed on biopsy. Blasts were positive for CD34 and MPO with strong membranous positivity for CD7. A final diagnosis of ‘Hypoplastic acute myeloid leukemia AML-M0’ was made. Conclusion: These cases pose a diagnostic challenge to the hematopathologist and treating physician, as hematological features of hypoplasticAML, hypocellularmyelodysplastic syndrome and aplastic anemia are similar. Therefore, it is crucial to distinguish between these diseases as treatment modalities are different for each entity.