Acute myeloid leukemia presenting in a human immunodeficiency virus-positive patient.

We report a case of AML in a 29-year-old HIV-positive female on anti-retroviral therapy. She presented with bicytopenia, fever and easy fatiquability. Bone marrow examination revealed 77% blasts, which on flow cytometric immunophenotyping showed positivity for myeloid lineage markers and were negative for monocytic and lymphoid lineage markers. Although rare, AML is seen in HIV patients, therefore, in presence of persistent cytopenias, detailed hematological evaluation should be done so as to not miss/delay the AML diagnosis.

A flow cytometric cell-cycle assay using methyl green.

Methyl green (MG), a conventional, low-cost histological stain, was used to design a flow cytometric cell-cycle/DNA-ploidy assay. On fluorometry, MG absorbed maximally at 633-nm, showed negligible fluorescence in free-state, but emitted brightly when bound to DNA. Optimal dye and cell concentrations for staining and effects of time and photobleaching on stained cells were determined for a lyse-permeabilize-stain protocol. Linearity of DNA-binding, coefficients-of-variation of G0/G1-peaks and minimal carryover were confirmed. Assay results correlated highly with a propidium iodide-based kit in 29 acute lymphoblastic leukemia specimens. The MG-based DNA-ploidy assay represented an accurate and inexpensive alternative to conventional PI-based assays.