TY - CHAP M1 - Book, Section TI - CHRONIC MYELOGENOUS LEUKEMIA AND THE MYELOPROLIFERATIVE DISORDERS A1 - Hillman, Robert S. A1 - Ault, Kenneth A. A1 - Leporrier, Michel A1 - Rinder, Henry M. PY - 2016 T2 - Hematology in Clinical Practice, 5e AB - CASE HISTORY • Part 1A 67-year-old woman is referred for evaluation of anemia. She complains of gradually increasing fatigue and has recently noticed some abdominal distention and weight loss. She also describes difficulty eating a full meal due to early satiety.Her past history is remarkable for the fact that several years ago she had been told by her gynecologist that she had very good blood counts with an elevated hematocrit and a tendency to a high white count. These findings were never evaluated. She had 2 uneventful pregnancies with no history of thrombosis or bleeding.On examination she appears somewhat cachectic and pale. Her abdominal examination is remarkable for hepatomegaly and striking splenomegaly; the spleen tip is palpated nearly at the pelvic rim.CBC: Hemoglobin/hematocrit - 7 g/dL/23%WBC count - 3,500/μL with a decreased neutrophil percentage, but otherwise relatively normal leukocyte differentialPlatelet count - 60,000/μLSMEAR MORPHOLOGYNumerous "teardrop" red cells are noted, as well as occasional nucleated red cells. White cells appear decreased in number with no morphological abnormalities. Platelets are also decreased in number, and giant platelets are seen.QuestionsWhat aspects of this case would lead the clinician away from a routine anemia workup?How many hematopoietic cell lines appear to be involved in this disorder?What additional laboratory studies are indicated? SN - PB - McGraw-Hill Medical CY - New York, NY Y2 - 2024/03/29 UR - hemonc.mhmedical.com/content.aspx?aid=1127767160 ER -