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Laboratory findings

Authoring team

  • red cells:
    • usually anaemia
    • cell morphology is abnormal with macrocytes, microcytes or bizarre shapes
    • MCV is normal or increased

  • WBC:
    • usually normal or reduced; but raised in chronic myelomonocytic leukaemia where monocyte count may exceed 10 x 10^9 / l
    • neutropenia is common; neutrophils may be hypogranular with one or two segments (Pelger-Huet cells), or may be hypersegmented

  • platelets - normal or reduced; some may be hypogranular

  • bone marrow - hypercellular despite low counts:
    • erythroid hyperplasia is common - abnormalities include megaloblastoid changes, nuclear budding or multinucleate erythroid precursors
    • granulocyte precursors often lack cytoplasmic granules
    • dwarf megakaryocytes with unilobed nucleus are characteristic

  • 60% of patients have chromosomal abnormalities most commonly 5, 7, 20, or Y, and trisomy 8.

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