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Autor*: Monika Antošová, A. Buliková, J. Kissová
Description:
29-years old female with accidentally established marked leukocytosis (144 G/l), thrombocytemia (913 G/l) and mild anemia (Hb 112 g/l). Peripheral blood and bone marrow smears give impression to chronic myelogenous leukemia in chronic phase. This suspicion is confirmed by detection of BCR-ABL fusion gene (b3a2).
Zařazení*:
Chronic myeloid leukaemia, BCR/ABL 1 positive
Přílohy*:
Description: Peripheral blood smear shows numerous granulocytes with predominate segmented neutrophils and myelocytes (four of them are in the picture). 
Description: Although predominant populations in peripheral blood smears in the disease represent mature segmented neutrophils and myelocytes, all type of immature cells of granulocytic lineage can occur. There are two bands in the picture (2 o'clock and 7 o'clock), and there is one promyelocyte (at 8 o'clock). 
Description: Basophils are almost invariable increased including immature forms in peripheral blood smears (to the right from the middle). Granulocytes show normal maturation. There are numerous thrombocytes in the smear. 
Description: Bone marrow is hypercellular with granulocytic and often megakaryocytic hyperplasia. Average size and lobulation of megakaryocytes' nucleoli is reduced. 
Description: Hyperplastic bone marrow with increased number of neutrophil segment and their precursors. Maturation pattern is similar to that in perifpheral blood - predominant populations represent mature neutrophils and myelocytes. There are three eosinofiphils in this part of slide (at 9, 3 and 4 o'clock). There isn't presence of significant dysgranulopoiesis . 
Description: Increased number of basophils (upper one at 10 o'clock) and mostly also of eosinophils (lower one at 10 o'clock; there is segmented neutrophil between these two cells) is typical feature of the disease. Eryhtropoiesis is reduced (slide shows no erythroid precursors). 
Description: Granulocytic lineage is increased and erythroid lineage is decreased in CML. There are only two early normoblasts here in the picture (at 8 and 9 o'clock). Myeloid:erhythroid ratio is 15:1 in this patient, but it can reach even value of 25:1. 
Description: Excess of granulocytic cells - the most of them are neutrophils in different stage of maturation including segmented ones, only two are eosinophils (one to the middle left and one to the middle right). Only one late erythroblast with pycnotic nucleus is underneath the centre of the picture. 
Description: Various stages of maturation in neutrophil lineage (one myeloblast in the centre, two segments and metamyelocyte). Only one early normoblast is under the myeloblast; beside it to the left is basophil.