1. Erythroid maturation

2. Proerythroblast

3. Basophilic erythroblast

4. Polychromatophilic erythroblast

6. Acidophilic erythroblast

7. Reticulocyte

8. Mature RBC

9. Erythroid Dysplasia

10. Myeloid maturation
Myeloblast Promyelocyte Myelocyte Metamyelocyte Band Neutrophil

11. Myeloblast

12. Promyelocyte

13. Myelocyte

14. Metamyelocyte

15. Mature neutrophil

16. ? ? ? ? ?

17. Megakaryoblas

18. Plasma cell

19. leukemia

20. Leukemia
A disorder characterised by the accumulation of malignant white cells in the BM and PB.
Acute leukemia
Chronic leukemia

21. Acute leukemia
A malignant disorder in which blasts constitute >20% of the BM cells
Classification:
Acute Myeloid Leukaemia (AML)
Acute Lymphoblastic Leukaemia (ALL)
The acute leukaemias are aggressive diseases in which the malignant transformation causes accumulation of early progenitor cells called blasts.
They are defined as the presence of >30% blasts in the bm.
They are subdivided into AML and ALL depending as to whether the blasts present are myeloblasts or lymphoblasts.

22. AML FAB classification
Acute myeloblastic leukemia ( M0, M1, M2 )
Acute promyelocytic leukemia ( M3, M3v )
Acute myelomonocytic leukemia ( M4, M4Eo )
Acute monocytic leukemia ( M5a, M5b )
Acute erythroleukemia ( M6 )
Acute megakaryocytic leukemia ( M7 )
According to the FAB classification AML is subdivided into 7 different categories, from M1 in which the cells present are very primitive through to the other categories in which the cells show more tendency to differentiate along normal cell lines.
In M5 the cells resemble monocytes. In M6 or erythroleukaemia the cells develop along the red cell pathway.
The newer classification from the WHO is slightly different in that its not so related to the morphology of the cells as to the aetiology……

23. Distinguishing AML from ALL
Light microscopy
AML: Auer rods, cytoplasmic granules
ALL: no Auer rods or granules.
Flow cytometry
Special stains (cytochemistry)

24. Cytochemistry AML Myeloblastic - SBB, MPO, Chloroacetate Esterase
Monoblastic - Non Specific Esterase
ALL
B lineage – PAS
T lineage – Acid Phosphatase

25. AML-M0

26. AML-M1

27. AML-M1

28. AML-M1 (MPO)

29. AML-M2

30. AML-M2 (MPO)

31. AML-M3

32. AML-M3 (MPO)

33. AML-M4E0

34. AML-M5a

35. AML-M5b

36. AML-M5a Cytochemistry NBE

37. AML-M6

38. AML-M6

39. AML-M7

40. AML-M7 (Dirty Field)

41. AML-M7 Cytochemistry MPO

42. AML-M7 (PAS)

43. CML

44. ALL-L1

45. ALL-L2

46. ALL-L3

47. CLL

48. PLL

49. HCL