Info

Laboratory

Myelogenous

With Myeloid

Polycythemia

Essential

Findings

Leukemia

Metaplasia

Vera

Thrombocythemia

Ph chromosome Present Spleen Normal/increased

Bone marrow Hypercellular predominantly granulocytic decreased iron stores

Ph chromosome Present Spleen Normal/increased

Bone marrow Hypercellular predominantly granulocytic decreased iron stores

Diagnostic Complete rainbow of all criteria stages of neutrophil maturation Less than 5% blasts in peripheral blood Ph chromosome present in 90% to 95% of cases Three clinical phases: Chronic Accelerated Blast

Absent Increased Increased fibrosis Megakaryocytic hyperplasia RBCs and WBCs usually normal Bone marrow aspirate DRY TAP

Leukoerythroblastic picture with teardrop RBCs Fibrotic marrow as disease progresses Enlarged spleen

Absent Increased

Hypercellular moderate to severe All three lines increased with normal maturation Deceased iron stores

Excessive RBC production Increased red cell volume, normal O2 saturation, all three lines increased Enlarged spleen

Absent

Normal/increased Hypercellular mild to moderate Megakaryocytic hyperplasia Clusters and sheets of megakaryocytes Some marrow fibrosis

Platelet count greater than 600,000/pL with no known cause for reactive thrombo-cytosis Complications of thrombosis and hemorrhage

Adapted from Finnegan K. Leukocyte disorders. In: Lehmann C, ed. Saunders Manual of Clinical Laboratory Science. Philadelphia: WB Saunders, 1998: 903-944.

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