Diagnosis for Cells Case #20

Chronic myeloid leukemia (CML) is a form of leukemia characterized by the increased and unregulated growth of predominantly myeloid cells in the bone marrow and the accumulation of these cells in the blood. In the blast phase, also known as blast crisis, there are 20% or more blasts in the blood or bone marrow or the leukemia blasts have spread outside of the bone marrow, and it is difficult to control the number of white blood cells. Additional genetic changes are also often found in the CML cells. The blast cells can look like the immature cells seen in acute lymphoblastic leukemia for about 25% of patients or acute myeloid leukemia for most patients. Patients in blast crisis often have a fever, an enlarged spleen, weight loss, and feel generally unwell.

In this case, the peripheral blood smear showed the neutrophil lineage in different stages of maturation. An increase in atypical basophils and eosinophils was also present. Moreover the blast percentage was 20%. The blast cell population was positive for CD34(partial), 19, 20(weak), 79a, 22 and 10. Subsequent cytogenetic analysis displayed a complex karyogram with 46,XY,t(9;22)(q34;q11) and additional accompanying cytogenetic abnormalities. In conclusion: CML in Blast Phase (BP).

Thank you input – please don’t forget that you are most welcome to contact us if you would like to share one of your interesting or challenging cases on the blog!

/ The CellaVision Blog Team

About the CellaVision Blog

This blog is created by CellaVision for laboratory professionals with a particular interest in hematology and digital cell morphology. Our aim is to inform, educate and inspire in equal measures – by highlighting interesting articles, sharing interesting patient cases and cell images, and presenting inspiring success stories from our community of CellaVision-users from around the world.

One thought on “Diagnosis for Cells Case #20”

  1. I was wondering whether or not this patient was a newly diagnosed leukemia. Myeloblasts particularly leukemic myeloblast have lower n:c ratios and rarely have nuclear contours demonstrating clefts or irregular contours.

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