Contributed by Rajendra Persad, MDPublished on line in June 2001
Contributed by Rajendra Persad, MD
Published on line in June 2001
PATIENT HISTORY:
The patient is a 58 year old white female who was diagnosed with Chronic Myeloid Leukemia (CML) positive for the Philadelphia chromosome by classical cytogenetics, seven months previously. A repeat bone marrow performed five months after diagnosis, to assess response to interferon and hydroxyurea treatment findings consistent with CML, with persistence of the Ph chromosome and less than 1% blasts. She is now being evaluated prior to bone marrow transplant.
PB Count:
| Hb | 11.1 g/dl | (normal 11.7 -15.7) |
| Plt | 246 x10E+9/L | (normal 150 -450) |
| WBC | 84.2 x10E+9/L | (normal 4.5 -11.0) |
| Blasts | (1%) 0.84 | (normal < 0.02) |
| Promyelocyte | (1%) 0.84 | |
| Promyelocyte | (1%) 0.84 | |
| Myelocytes | (5%) 4.21 | |
| Metamyelocytes | (9%) 7.58 | |
| Bands | (23%) 19.37 | (normal 0.1 -0.8) |
| Polys | (43%) 36.22 | (normal 2.0 - 6.8) |
| Basophils | (2%) 1.68 | (normal < 0.2) |
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A bone marrow aspirate (Images 5, 6, 7 and 8) and biopsy was performed (Images 9 and 10) with the following differential:
| Blasts | 19% (normal 0.0 -2.0) |
| Basophils | 5.3% (normal 0.0 - 0.2) |
| M:E ratio | 6.1% (normal 1.5 - 3.3) |
The biopsy demonstrated marked cellularity (~100%), with many blasts. Erythroid maturation is slightly megaloblastoid. Myeloid maturation showed left shift. Occasional micromegakaryocyte were identified.
Flow Cytometry:
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Flow Cytometry:
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