20. CML-CP smear

Much higher WBC/RBC ratio than normal

Staining: May Grunwald-Giemsa

Organ: Blood smear

Description:

There is a marked increase in the number of WBCs compared to normal. Not only mature cells are visible (neutrophils, basophils, eosinophils), but also immature cells.

Diagnosis: Chronic phase of chronic myeloid leukaemia

Causes:

• Philadelphia chromosome (t(9;22))

Theory:

Mature and immature cells

The CML slide I have is different than the one in class, so there’s no point in an overview picture. The characteristics are the same anyway.

CML involves an extreme proliferation of the myeloid cell line, which includes those cell lines that develop from myeloblasts into basophils, eosinophils and neutrophils (not monocytes). Because of this can we see many immature WBCs in the peripheral blood smear. These immature cells are large, have small cytoplasm and large nuclei.

The cell types you must recognize are mature neutrophils (segmented nucleus) and immature cells.