This is the Wright's stained bone marrow aspirate from the case presented in the previous slide. The lymphoblasts are numerous and are identical to those seen in the peripheral blood; they constitute more than 90% of the bone marrow cells. In normal bone marrow, lymphoblasts cannot easily be identified. As is usually the case in ALL, this marrow is hypercellular, even though the normal myeloid and erythroid cells are greatly decreased in number. In contrast to the acute myeloid/erythroid leukemias, the few myeloid and erythroid cells present in ALL have a relatively normal cytologic appearance. Because these normal bone marrow cells are replaced by lymphoblasts, anemia and reduced platelet counts are usually characteristic of patients with ALL.
Course Section: 07. Lymphocytic Leukemia: Acute and Chronic
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