Clinical Case 13 - Acute myeloid leukemia

Patient demography: Female, 50 years old
Diagnosis: Severe pancytopenia (anemia thrombocytopenia and leukopenia) caused by an acute myeloid l eukemia.
Biochemical test results: C reactive protein (CRP) 25 mg/dl; lactate dehydrogenase (LDH) 354 mg/dl.
Other information: Asthenia and fever that were related to an acute pharyngitis.
Microscopic review:Neutropenia and immature cells (myeloid blasts); immature granulocytes are present with a good correlation in percentage detected by the Yumizen H2500 analyzer. We observe anisopoikilocytosis (presence of erythrocytes of varying size and shape) related to the stress in the normal maturation of the cells in the bone marrow.
Those are common morphological features observed in this clinical condition. 2% of nuclear red blood cells (NRBC) are detected without any abnormal morphological changes. In this type of case, monoblasts may interfere with monocyte count.
Analyzer: Yumizen H2500/H1500
Case provided by: Anna Marull, Maite Serrando, Laboratori Clinic Territorial IAS-ICS, Girona, Spain