Acute Leukaemia is an abnormal proliferation of blasts in either the myeloid or lymphoid cell lines. The rapidly proliferating blasts dramatically affect the bone marrow, leading to pancytopaenia.
Compared to chronic leukaemia, acute leukaemia is more common in younger patients.
Easy bruising and bleeding due to thrombocytopenia
Increased susceptibility to infection due to leukopenia and non-functional leukocytes)
Investigations
Bone marrow biopsy – This is the most accurate test. > 20% blasts are needed to make the diagnosis of acute leukaemia
Identifying features of blast cells
Blasts are generally larger
Blasts have an increased nuclear-cytoplasm ratio,
Blasts have a deep-blue cytoplasmic staining (mature cells stain lighter)
Blasts have irregular nuclear contour
Blasts have immature chromatin (salt and pepper; mature chromatin is more condensed)
Blasts have prominent nucleoli
Morphological identifying features of cells in the myeloid series
Myeloblast: High nuclear-cytoplasmic ratio, immature chromatin, prominent nucleoli (3-4)
Promyelocyte: High-nuclear-cytoplasmic ratio (though more cytoplasm than myeloblasts), round nucleus with immature chromatin, prominent nucleoli, cytoplasm shows primary azurophilic granules
Myelocyte: Eccentric oval nucleus with no indentation, mature chromatin (condensed), absent nucleoli, more cytoplasm, fewer primary granules and more secondary azurophilic granules ***Last stage that cells can undergo mitosis in
Metamyelocyte: Kidney-bean-shaped nucleus with an indented nucleus (note that the indentation is less than half the diameter of the nucleus), mature chromatin, and only secondary granules
**Band form (Juvenile):**Kidney bean shaped with an indented nucleus (more than half the diameter of the nucleus), more cytoplasm, and secondary granules)
Segmented neutrophil: Mature nucleus divided into 3-5 lobes with thin chromatin filaments and secondary granules
Immunophenotypical identifying features of cells in the myeloid and lymphoid series
