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Comprehensive Protocol to Sample and Process Bone Marrow for Measuring Measurable Residual Disease and Leukemic Stem Cells in Acute Myeloid Leukemia
Published on: March 5, 2018
La importancia de la biopsia de médula ósea para la clasificación de la leucemia mieloide crónica: un reporte de caso
Natália Vital Gonçalves1, Herton Luiz Alves Sales Filho2, João Paulo Cabral de Magalhães Gomes2
1Division of Anatomic Pathology, Department of Pathology, School of Medical Sciences, University of Campinas (Unicamp), Campinas, Brazil.
Abstract:
Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm characterized by the BCR::ABL1 rearrangement, usually diagnosed by data of peripheral blood, bone marrow cytology, cytogenetics, and the detection of the BCR:ABL1 rearrangement. An accurate diagnosis, including the precise phase of the disease, is essential to guide appropriate treatment. We present the case of a patient admitted at our Institution with the hypothesis of CML in chronic phase, based on clinical and bone marrow cytological findings. Bone marrow biopsy showed some areas with morphologic features of CML in chronic phase but also sheets of B lymphoblasts, compatible with lymphoid blast crisis. Flow cytometry detected 1.18% of lymphoblasts. This report clearly illustrates the importance of the examination of bone marrow by several techniques. It highlights the importance of the biopsy in recognizing anomalous immunomorphological patterns, which can lead to diagnostic and therapeutic changes in CML.

