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A 26-year-old woman was referred for progressive fatigue, dyspnea, blurred vision, and near-syncope. At presentation, she had marked pallor, pyrexia, diffuse nontender lymphadenopathy, and both preretinal and retinal hemorrhages. The initial laboratory examination revealed a leukocyte count of 249,000 per cubic millimeter, a hemoglobin concentration of 29 g per liter (normal range, 115 to 160), and a platelet count of 48,000 per cubic millimeter. A peripheral-blood smear (Panel A, Wright–Giemsa, x500), showed numerous blast forms. After the peripheral-blood samples drawn at presentation had settled, they revealed a large buffy coat of green leukemic cells (Panel B, arrow); blood from . . . [Full Text of this Article] |
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