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A 56-year-old Female with no significant medical history is admitted to the hospital with an acute left subdural hematoma after a Fall. Physical examination is significant For normal mental status. diffuse ecchymoses, and massive splenomegaly. Patient denies preceding abdominal pain. weight loss. Fevers. or night sweats. Laboratory evaluation shows leukocyte count of 119.000/pl. hemoglobin 8 g/dl. and platelet count 1 02,000/pl. Eosinophil and basophil counts are normal. Peripheral slide is shown below.
Bone marrow biopsy was obtained and revealed hypercellularity with increased number of my eloid blasts at 15%. What is the final diagnosis?
- Chronic myelomonocytic leukemia type 1 (CMML-1)
- Chronic myelomonocytic leukemia type 2 (CMML-2)
- Acute myeloid leukemia (AML)
Medicine
B. Presence of 10% to 19% bone marrow blasts supports the diagnosis of CMML-2. Cases of CMML-1 are diagnosed when bone marrow blast count if less than 10%, while bone marrow blast count in excess of20% is diagnostic of AML (Br] Haematol. 2011;153(2):149).
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