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Oncohematology

Acute Leukemia: Blood Count Dynamics and Blasts in Smear

A clinical case of acute leukemia manifestation: transformation from leukopenia to leukocytosis with the appearance of blasts in peripheral blood over a month.

Darya Todzhaeva Darya Todzhaeva 1 min
Complete blood count form from 17.01.20: leukopenia 3.5 thousand/µL and normocytic anemia
Complete blood count form from 17.01.20: leukopenia 3.5 thousand/µL and normocytic anemia
Blood test form from 21.01.20: leukopenia 3.1 thousand/µL and severe neutropenia
Blood test form from 21.01.20: leukopenia 3.1 thousand/µL and severe neutropenia
Blood test form from 06.02.20: leukocyte increase to 9.7 thousand/µL and 16% blasts
Blood test form from 06.02.20: leukocyte increase to 9.7 thousand/µL and 16% blasts
Blood test form from 10.02.20: leukocytosis 26.7 thousand/µL and blast increase to 29%
Blood test form from 10.02.20: leukocytosis 26.7 thousand/µL and blast increase to 29%
Blood smear: blast cell with delicate nuclear chromatin and basophilic cytoplasm
Blood smear: blast cell with delicate nuclear chromatin and basophilic cytoplasm
Blood smear: two blasts and a segmented neutrophil in the field of view
Blood smear: two blasts and a segmented neutrophil in the field of view
Blood smear: blast cell with eccentric nucleus and basophilic cytoplasm
Blood smear: blast cell with eccentric nucleus and basophilic cytoplasm

A 64-year-old male. Admitted to a psychiatric ward. Over the course of a month, changes were observed in the complete blood count (CBC) that could be interpreted as the onset of acute leukemia. From a slight leukopenia of about 3,000, leukocytes increased to 25,000, and blasts appeared, reaching up to 29%. The attached photos of blasts were taken on 06.02.20, when leukocytes were 9.7 and blasts were 16%.

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