Page 122 - Haematologica Atlas of Hematologic Cytology

Figure 1 Therapy related acute myeloid leu e e e e e e e e mia Bone marrow smear from a a a a a a 74-year-old man previously treated with alkylating agents for Wal- denström macroglobulinemia eight years later he developed macrocytic anemia severe throm- bocytopenia and mild leukopenia Note the hyperplasia and macro-megaloblastoid features of of the the erythroid lineage hypoplasia of of the the gra- nulocytic lineage some lymphocytes and three blast cells Figure 1 Therapy related acute myeloid leu e e e e e e e e mia The same bone marrow smear as in Figure 16 showing a a a group of small-medium sized blasts with rather abundant cytoplasm The blast count was 40% of all all bone marrow cells allowing the diagnosis of acute leukemia Figure 1 Therapy related acute myeloid leu e e e e e e e e mia Bone marrow smear from the same case as as Figures 16 and 17 Sudan black staining is positi- ve in in most blasts confirming their myeloid com- mitment Therapy-related myeloid neoplasms
include therapy-related acute myeloid leukemias myelodysplastic myelodysplastic syndromes and myelodysplastic/ myeloproliferative neoplasms
based on the num- ber of blasts in the blood and/or bone marrow They occur as a a a a late complication of cytotoxic chemotherapy (alkylating agents or topoisome- rase II inhibitors) and/or radiation therapy admi- nistered for a a a prior neoplastic neoplastic or or or non-neoplastic disorder 109