This is the bone marrow preparation of a patient with EL, FAB classification M6. Please note the erythroid hyperplasia. There are more NRBCs in this field than there are leukocytes. For you to make the diagnosis of EL, the myeloid-to-erythroid (M:E) ratio should be at least 1:1, and it might be as low as 1:5. Note also in this marrow the multinucleated red blood cells, which are another feature of this disease. Iron stains of the bone marrow usually reveal an increased number of ringed sideroblasts. The erythrocytes may be macrocytic, but generally the serum B12 and folate levels are normal or increased. The blood differential usually shows young granulocytes and an increase in monocytes. The number of NRBCs, in the blood is variable, from none to many.
Course Section: 09. Acute Myelomonocytic Leukemia - Monocytic Leukemia - and Erythroleukemia
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