Question of the Week

For July 7, 2020

A 76-year-old woman reports a 2-month history of worsening fatigue and abdominal pain. She states that she has not had any fevers, chills, or recent infections.

On examination, she has splenomegaly and scattered ecchymoses on her lower extremities.

Laboratory results from both today and 6 months ago are as follows:

Patient value 6 months ago

Current patient value

Reference range

Leukocyte count (per mm3)

15,300

135,500

4500–11,000

Neutrophils (%)

60

69

40–70

Lymphocytes (%)

15

8

22–44

Eosinophils (%)

5

5

0–8

Basophils (%)

5

8

0–3

Myelocytes (%)

10

Promyelocytes (%)

0

Blasts (%)

0

Hemoglobin (g/dL)

12.2

10.6

12.0–16.0

Platelet count (per mm3)

468,000

549,000

150,000–350,000

Which one of the following diagnoses is most likely in this case?

Chronic myeloid leukemia
Acute myeloid leukemia
Leukemoid reaction
Chronic lymphocytic leukemia
Acute promyelocytic leukemia