Which type of leukemia is indicated by alpha-naphthol-As-D-acetate esterase (NASDA) results of 3+ and NASDA with sodium fluoride (NaF) results of 1+?

The results of the alpha-naphthol-As-D-acetate esterase (NASDA) test play a significant role in distinguishing between different types of leukemia. A result of 3+ for NASDA indicates a high level of esterase activity, which is typically associated with myeloid cells. In this context, acute myeloid leukemia (AML) would show a strong positivity for esterase.

The presence of sodium fluoride reduces the activity of the enzyme, which is evident in the 1+ result. The combination of a high esterase activity without fluoride suppression points towards acute myelomonocytic leukemia (AMML), which is characterized by a mixed population of myeloid and monocytic cells. The 3+ result suggests that there are significant monocytic components, which correlates well with the designation of AMML.

Hence, the specific pattern of the esterase results—high activity in the presence of NASDA and moderate activity in the presence of sodium fluoride—correctly identifies AMML as the type of leukemia indicated in this question. AMML showcases both myeloid and monocytic features, reflecting the enzyme activity observed in these test results. This interpretation is aligned with the characteristic enzymatic behaviors associated with this particular leukemia type