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A case of aCML. (Left) BM biopsy (hematoxylin and eosin, ×500) reveals a hypercellularity (100%) with markedly increased myeloid:erythroid ratio (26:1). Dysplastic megakaryocytes are indicated by arrows; (right) PB smear (Wright Giemsa, ×1000) shows marked leukocytosis with many myeloid precursors (promyelocytes, myelocytes, and metamyelocytes, 23%). Neutrophils show peculiar abnormal nuclear segmentation. In the 2008 WHO classification, aCML is defined by “persistent leukocytosis (=13 × 109/L) with immature circulating myeloid precursors (=10% of leukocytes) and marked dysgranulopoiesis, with absent/minimal monocytosis (<1 × 109/L and <10% of leukocytes) or basophilia (often <2%).” The presence of BCR-ABL1 or rearrangements of PDGFRA, PDGFRB, or FGFR1 precludes a diagnosis of aCML and any MDS/MPN subtype.
Atypical chronic myeloid leukemia
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Author: Sa A. Wang, Robert P. Hasserjian, Patricia S. Fox, Heesun J. Rogers, Julia T. Geyer, Devon Chabot-Richards, Elizabeth Weinzierl, Joseph Hatem, Jesse Jaso, Rashmi Kanagal-Shamanna, Francesco C. Stingo, Keyur P. Patel, Meenakshi Mehrotra, Carlos Bueso-Ramos
Category: Myeloid Neoplasms and acute leukemia (WHO 2016) > Myelodysplastic/myeloproliferative neoplasms (MDS/MPN) > Atypical Chronic Myeloid Leukemia (aCML), BCR-ABL1 negative
Published Date: 04/27/2014
Category: Myeloid Neoplasms and acute leukemia (WHO 2016) > Myelodysplastic/myeloproliferative neoplasms (MDS/MPN) > Atypical Chronic Myeloid Leukemia (aCML), BCR-ABL1 negative
Published Date: 04/27/2014
A case of aCML. (Left) BM biopsy (hematoxylin and eosin, ×500) reveals a hypercellularity (100%) with markedly increased myeloid:erythroid ratio (26:1). Dysplastic megakaryocytes are indicated by arrows; (right) PB smear (Wright Giemsa, ×1000) shows marked leukocytosis with many myeloid precursors (promyelocytes, myelocytes, and metamyelocytes, 23%). Neutrophils show peculiar abnormal nuclear segmentation. In the 2008 WHO classification, aCML is defined by “persistent leukocytosis (=13 × 109/L) with immature circulating myeloid precursors (=10% of leukocytes) and marked dysgranulopoiesis, with absent/minimal monocytosis (<1 × 109/L and <10% of leukocytes) or basophilia (often <2%).” The presence of BCR-ABL1 or rearrangements of PDGFRA, PDGFRB, or FGFR1 precludes a diagnosis of aCML and any MDS/MPN subtype.
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