Global test 2023:4 - CML
Case Description
A 60-year-old man with chronic myeloid leukemia presented with fatigue, fever, night sweats, and unexplained weight loss.
Laboratory Findings
| Test | Result | Reference Interval | Unit |
|---|---|---|---|
| WBC | 116 | 4.5-11.5 | x109/L |
| RBC | 2.39 | 3.5-5.5 | x1012/L |
| HGB | 7.7 | 14-17.5 | mg/dL |
| HCT | 24.5 | 40-54 | % |
| MCV | 102.5 | 80-100 | fL |
| MCH | 32.2 | 27-31 | pg |
| MCHC | 31.4 | 32-36 | g/dL |
| RDW | 21.8 | 11.5-15 | % |
| PLT | 79 | 150-450 | x109/L |
| Retic | 5.41 | 0.5-2.5 | % |
| 129.3 | 20-80 | x109/L | |
| IRF | 39.9 | 2.3-15.9% | % |
Sample of cells classified in the Global Test 2023:4
RBC Overview
Case Conclusion
CBC data indicate leukocytosis, anemia, and thrombocytopenia. Blood smear showed left-shifted neutrophilia with all stages of immaturity present, from myeloblasts (3%) to mature neutrophils. Some of the immature neutrophils appeared hypogranular which complicated cell identification. Characteristic peaks in the percent myelocytes and mature neutrophils were also noted. Eosinophils, some immature and basophils were increased; and 3 NRBCs, including a polychromatic erythroblast and mitotic figure were counted. RBC morphology was slightly abnormal.
Global Test 2023:4 Results Webinar
Questions discussed during the webinar include:
- Compare participant and examiner results, and cells that were most challenging
- Discuss the pathophysiology and clinical/laboratory features of chronic myeloid leukemia including characteristic blood smear findings
- Discuss pseudomacrocytosis in samples with very high WBC counts
- Differentiate CML from disorders with similar morphology
- Identify CML patients with progressive disease
- Discuss the role of targeted therapies