Erythroid maturation Proerythroblast Basophilic erythroblast Polychromatophilic erythroblast Acidophilic

Erythroid maturation

Proerythroblast

Basophilic erythroblast

Polychromatophilic erythroblast

Acidophilic erythroblast

Reticulocyte

Mature RBC

Erythroid Dysplasia

Myeloid maturation Myeloblast Neutrophil Promyelocyte Metamyelocyte Band

Myeloblast

Promyelocyte

Myelocyte

Metamyelocyte

Mature neutrophil

Megakaryoblas

Plasma cell

leukemia

Leukemia A disorder characterised by the accumulation of malignant white cells in the BM and PB. • Acute leukemia • Chronic leukemia

Acute leukemia A malignant disorder in which blasts constitute >20% of the BM cells Classification: • Acute Myeloid Leukaemia (AML) • Acute Lymphoblastic Leukaemia (ALL)

AML FAB classification • Acute myeloblastic leukemia ( M 0, M 1, M 2 ) • Acute promyelocytic leukemia ( M 3, M 3 v ) • Acute myelomonocytic leukemia ( M 4, M 4 Eo ) • Acute monocytic leukemia ( M 5 a, M 5 b ) • Acute erythroleukemia ( M 6 ) • Acute megakaryocytic leukemia ( M 7 )

Distinguishing AML from ALL • Light microscopy q. AML: Auer rods, cytoplasmic granules q. ALL: no Auer rods or granules. • Flow cytometry • Special stains (cytochemistry)

Cytochemistry AML • Myeloblastic - SBB, MPO, Chloroacetate Esterase • Monoblastic - Non Specific Esterase ALL • B lineage – PAS • T lineage – Acid Phosphatase

AML-M 0

AML-M 1

AML-M 1

AML-M 1 (MPO)

AML-M 2

AML-M 2 (MPO)

AML-M 3

AML-M 3 (MPO)

AML-M 4 E 0

AML-M 5 a

AML-M 5 b

AML-M 5 a Cytochemistry NBE

AML-M 6

AML-M 6

AML-M 7

AML-M 7 (Dirty Field)

AML-M 7 Cytochemistry MPO

AML-M 7 (PAS)

CML

ALL-L 1

ALL-L 2

ALL-L 3

CLL

PLL

HCL