CellaVision Global Test 2026:2 – Acute Promyelocytic Leukemia (APL)

Case Description

A 42-year-old man presented with a two-week history progressive weakness, fatigue and dizziness. He reported bleeding gums, tiny red spots on arms and legs and widespread bruising as well as tiredness and recurring fever and infections.

Laboratory Findings

Complete blood count (CBC):

Test	Result	Reference Interval (male)	Unit
WBC	2.3	4.0 - 10.0	x10⁹/L
RBC	3.35	4.5 – 5.9	x10⁹/L
HGB	11.1	13.5 – 17.5	g/dL
HCT	33.1	41 – 53	%
PLT	6	150 – 400	x10⁹/L

Cell Counter Differential:

Test	Result (x10⁹/L)	Unit (%)
Neutrophils	0.10	16.2
Lymphocytes	0.71	---
Monocytes	1.40	---
Eosinophils	0.00	0.5
Basophils	0.06	0.4
IG	---	0.9
NRBC	0.08	0.0

WBC flags: Monocytosis, Blasts, Immature Gran, Atypical Lympho?

Analysis Details

Stain: May–Grünwald–Giemsa

Analyzer: CellaVision DC-1, CDMS 7.2, LED Microscope mode

Sample of cells classified in the Global Test 2026:2

RBC Overview

Smear Interpretation

Peripheral blood smear examination reveals leukopenia with 56% blast cells. According to ICSH recommendations, abnormal promyelocytes were included in the blast count. These cells display abundant granular cytoplasm, irregular nuclear contours, and occasional Auer rods. Additional findings include severe thrombocytopenia, occasional giant platelets, left-shifted granulopoiesis, and circulating nucleated red blood cells.

Diagnosis

Acute Promyelocytic Leukemia (APL) is a distinct subtype of acute myeloid leukemia characterized by the accumulation of abnormal promyelocytes in the bone marrow and peripheral blood. The disease is often associated with cytopenias, bleeding manifestations, and the presence of abnormal promyelocytes with abundant granules and Auer rods.

Global Test 2026:2 Results Webinar

Case presentation
DC-1 Analysis - the WBC differential and RBC Characterization
Differences in classification between examiner and participants
Discussion about APL – From symptoms to laboratory diagnosis