Dysmyelopoietic syndromes include a range of conditions for which immediate treatment is not indicated. The names that have been applied to these conditions include preleukemia, chronic myelomonocytic leukemia, smoldering leukemia, subleukemic leukemia and refractory anemia with an increase in blasts. Shown on this slide is the bone marrow of a 58-year-old man who was considered to have preleukemia because the bone marrow was abnormal but not diagnostic. The laboratory findings that usually suggest dysmyelopoiesis are peripheral blood cytopenias. The differential may show an absolute monocytosis, pseudo-Pelger-Huet cells (mononuclear neutrophils with dense, heavy chromatin), a rare NRBC, and a few young forms of granulocytes. The bone marrow usually is hypercellular with a variable degree of abnormal morphology of erythroblasts and megakaryocytes. Usually the marrow contains less than 25% blasts. Since all patients with these features do not progress to acute leukemia, the diagnosis of preleukemia can be made conclusively only in retrospect.
Course Section: 09. Acute Myelomonocytic Leukemia - Monocytic Leukemia - and Erythroleukemia
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