Question

A 26-yr old male presents to the emergency room with a history of fatigue, fever, and gingival bleeding for the past 3 days. The patient's WBC is 17,000/µL, Hgb 9.4 g/dL, PLTs 72,000/µL. The WBC differential showed 19% lymphocytes, 15% monocytes, 6% eosinophils, 60% other cells which were heavily granulated and contained Auer Rods. A FISH analysis revealed a t(15;17) translocation.The patient was treated with retinoid acid. These results are treatment option are consistent with:

Answer 1

In a patient with acute myelogenous leukemia (AML), one would expect impaired production of erythrocytes due to the overproduction of malignant myeloblasts in the bone marrow, inhibiting the production of normal blood components.

Step-by-step explanation:

A patient with acute myelogenous leukemia (AML) would likely experience impaired production of erythrocytes rather than lymphocytes. AML is a type of cancer originating from the myeloid line of blood cells, which includes erythrocytes, platelets, and certain types of leukocytes, excluding lymphocytes which derive from a different lineage. The presence of heavily granulated cells with Auer Rods and the t(15;17) translocation indicated in the FISH analysis confirm the diagnosis of AML, specifically acute promyelocytic leukemia (APL), a subtype of AML. The use of retinoic acid is a targeted treatment for APL to induce differentiation of the malignant cells.

Impaired production of erythrocytes is expected in this case because the overproduction of myeloblasts in the bone marrow inhibits the normal production of non-leukocytic blood components. This is due to the 'crowding out' effect, where malignant cells take up space and resources in the bone marrow leading to a decrease in the production of other blood cells including erythrocytes.