Bone Marrow, Polycythemia, and Leukemia

Question 1

Describe adequate cellularity and inadequate cellularity in a bone marrow sample

Answer 1

Adequate: a lot of cells, little fat
Inadequate: large amount of fat, few cells

Question 2

What is the range of normal ratio for myeloid:erythroid?

Answer 2

1:1 - 3:1

Question 3

What are the possible reasons for an increased myeloid:erythroid ratio?

Answer 3

• Erythroid hypoplasia or aplasia

- Granulocytic hyperplasia or leukemia (increased neutrophil)

Question 4

What are the possible reasons for a decreased myeloid:erythroid ratio?

Answer 4

• regenerative anemia
• erythroid leukemia
• lack of production neutrophils

Question 5

The presence of plasma cells in a bone marrow aspirate may indicate what?

Answer 5

antigenic stimulation or plasma cell neoplasia

Question 6

What are the indications for a bone marrow aspirate?

Answer 6

• Non-regenerative anemia
• Neutropenia
• Thrombocytopenia
• Suspected neoplasm or monoclonal gammopathy
• To better classify leukemia

Question 7

What is relative polycythemia?

What are the causes?

Answer 7

• increased red cell concentration where RBC mass has not increased, but the liquid portion of the blood has decreased
• Causes: dehydration, fluid shifts, contracted spleen, increased epinephrine (excitement)

Question 8

What is absolute polycythemia?
What are the causes?
Appropriate and Inappropriate

Answer 8

• Increase in RBCs
• Causes: increased erythropoeitin (increased RBC production), and polycythemia vera (myeloproliferative disorder
• Appropriate: chronic hypoxia
• Inappropriate (EPO secretion): renal cysts, tumors

Question 9

What is seen in a bone marrow aspirate of and animal with Acute Lymphoblastic Leukemia?

Answer 9

• More immature cells (blasts), most will look the same
• Blasts are large with nucleoli in nucleus
• Pieces of cytoplasm from broken cells

Question 10

What are the CBC abnormalities associated with Acute Lymphoblastic Leukemia?

Answer 10

• anemia
• thrombocytopenia
• leukocytosis
• immature cells in blood

Question 11

What are the CBC abnormalities associated with Chronic Granulocytic Leukemia?

Answer 11

• marked neutrophilia, left shift
• monocytosis
• marked leukocytosis

Question 12

What are some CBC abnormalitites seen in Myelodysplastic Syndromes?

Answer 12

• non-regenerative anemia
• neutropenia
• thrombocytopenia

Question 13

What are some CBC abnormalities seen in Chronic Basophilic Leukemia?

Answer 13

• basophilia
• orderly left shift
• possible thrombocytosis