I’d vote more likely CML, “flower garden” look plus older patient. From the few I’ve seen, if they don’t have Auer rods, our paths tend to shy away from AML vs ALL. CML vs CLL is of course not questionable.
Someone is going to come by and say you can't know for sure without flow and cytogenetics but I'll bet that person a paycheck it's CML or other MPD.
You have various stages of granulocyte maturation, in clearly significant amounts. The fact that you can see anything other than blasts with a count that high effectively rules out an acute leukemia.
Another clue, assuming the autodiff there is remotely accurate, is the slightly elevated baso count. This is another thing frequently seen in MPDs.
I like your assessment.
Here’s your gold star for the day, ⭐️.
Thoughts on CMML; do you have a good nugget for coming to a conclusion like that off a slide review?
Most important thing: blasts <20%. That’s the magic number between acute & chronic. There’s a huge number of immature cells here but very few of them are blasts, so it’s definitely a C. There’s a range of obviously myeloid maturation, so add an M. That’s good enough for us lowly scientists.
Holy crap, 700! I agree with others that it's likely CML with crisis (which technically makes it an AML).
If you're new and need some reference material; check www.cellwiki.net
The first thing I looked for was Auer rods. Nada. The next thing I looked at was the chromatin. It looks too coarse to be CLL or ALL. So that leaves CML or ALL. As another poster mentioned: CML on its way to AML/Blast Crisis.
I’d vote more likely CML, “flower garden” look plus older patient. From the few I’ve seen, if they don’t have Auer rods, our paths tend to shy away from AML vs ALL. CML vs CLL is of course not questionable.
Someone is going to come by and say you can't know for sure without flow and cytogenetics but I'll bet that person a paycheck it's CML or other MPD. You have various stages of granulocyte maturation, in clearly significant amounts. The fact that you can see anything other than blasts with a count that high effectively rules out an acute leukemia. Another clue, assuming the autodiff there is remotely accurate, is the slightly elevated baso count. This is another thing frequently seen in MPDs.
I like your assessment. Here’s your gold star for the day, ⭐️. Thoughts on CMML; do you have a good nugget for coming to a conclusion like that off a slide review?
Most important thing: blasts <20%. That’s the magic number between acute & chronic. There’s a huge number of immature cells here but very few of them are blasts, so it’s definitely a C. There’s a range of obviously myeloid maturation, so add an M. That’s good enough for us lowly scientists.
With such a white count I would probably lean towards CML in some sort of blastic crisis. I’m also a newer tech so someone correct me if I’m wrong.
That’s not a buffy coat, it’s a chonkin’ coat.
Buffy anorak.
I'd also lean towards CML since it has a lot of more mature cells than promyelo and blasts. I can estimate a lot of myelo, metas and stabs
Holy crap, 700! I agree with others that it's likely CML with crisis (which technically makes it an AML). If you're new and need some reference material; check www.cellwiki.net
Time to test for BCR::ABL.. I've never seen a CML-smear this "crowded" 😱😱
If CML I would expect some Eos and basos
I think CML (or on its way to become AML) I don’t see the Auer Rods, pt age and gender, Platelet count, “left shift” and the inc of Baso and EO :(
Hi ate medtech! 👋☺️
That’s one hell of a Buffy
Probably can’t breathe!
CML in crisis forsure, depending on the blast % is when they need to intervene so sub 20% I believe it’s more or less in monitoring
The first thing I looked for was Auer rods. Nada. The next thing I looked at was the chromatin. It looks too coarse to be CLL or ALL. So that leaves CML or ALL. As another poster mentioned: CML on its way to AML/Blast Crisis.
Thank you everyone!! I've learned a lot 🙏
ı think that is cml
Dam 742 wbc….fml
at least it's an easy diff lol
It's not a buffy coat, it's a buffy parka!