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Slide 30
This is the bone marrow preparation of the same patient 18 months later. It has become frankly leukemic because more than 50% of the cells are blasts. Dysmyelopoietic syndromes may progress to acute leukemia in as many as 30% of all cases. The preleukemic phase may extend over a period of ten years, but usually it lasts one or two years before unequivocal leukemia develops. The development may be slowly progressive, or it may be explosive. Dysmyelopoiesis is seen in many elderly patients who die of other causes without developing leukemia. In rare instances the manifestations of preleukemia may disappear. Patients with dysmyelopoiesis require periodic blood counts, and if substantial changes occur, bone marrow examination for possible progression to acute leukemia is indicated.

HEMATOLOGY
Course Section: 09. Acute Myelomonocytic Leukemia - Monocytic Leukemia - and Erythroleukemia
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