Page 187 - Clinical Hematology Atlas

CHAPTER 17 MYELOPROLIFERATIVE NEOPLASMS 171

MORPHOLOGY
Peripheral Blood: Chronic phase*
LEUKOCYTES
Marked leukocytosis (12-1000 3 10 /L)
9
• Spectrum of myeloid cells with a predominance of myelocytes and segmented
neutrophils
• Myeloblasts ,5%
• 6 Pseudo-Pelger-Huët cells
• Basophilia
• Eosinophilia
• 6 Monocytosis
• Leukocyte alkaline phosphatase (LAP) markedly decreased (Figure 17-2)
ERYTHROCYTES
Normal or decreased in number

PLATELETS
• Normal or increased
• 6 Circulating micromegakaryocytes

Bone Marrow:
• Hypercellular with expansion of granulocyte pool
• Myeloid:Erythroid (M:E) ratio increased
• Myeloblasts ,5%
• Megakaryocytes normal to increased; may be immature and/or atypical
• 6 Pseudo-Gaucher cells (see Figure 22-1A)
• 6 Sea blue histiocytes (see Figure 22-5A)

*Before development of tyrosine kinase inhibitors for treatment, CML would progress through phases,
from chronic to accelerated to blast phase, with increasing numbers of blasts, basophils, micromega-
karyocytes, and dysplasia. (See a hematology textbook for complete discussion of progression of CML.)