Diagnostic Challenging Case of Hypoplastic Acute Myeloid Leukemia with Literature Review

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% in bone marrow with >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. These cases pose a diagnostic challenge to the hematopathologist and treating physician, as hematological features of hypoplastic acute myeloid leuckemia (AML), hypocellular myelodysplastic syndrome and aplastic anemia are similar. Therefore, it is crucial to distinguish between these diseases as treatment modalities are different for each entity. Very few reported cases are available in literature. Hereby, we report this case of hypocellular AML-M0 in a 16-years-old Indian boy.