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B cell ALL case demonstrating the rapid WBC rise

Author:  Katherine Calvo, MD, PhD, 09/21/2015
Category: Myeloid Neoplasms and acute leukemia (WHO 2016) > Precursor Lymphoid Neoplasms > B-lymphoblastic leukemia/lymphoma > B-Lymphoblastic Leukemia/Lymphoma, not otherwise specified
Published Date: 02/25/2016
     
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4 y/o female with cirrhosis of the liver and falling platelet counts.  Case shows the dramatic increase in WBC in peripheral blood.

Peripheral Blood

ALL case demonstrating the rapid WBC rise in a child with B cell ALL.  

Peripheral blood blasts  from 4 y/o female with cirrhosis of the liver and falling platelet counts.

Smear shows numerous blast forms.  

B-cell-ALL-peripheral-blood
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Flow cytometry

Flow cytometry analysis of peripheral blood.  The blasts (red) represent approximately 43% of the WBC and are dim to negative for CD45; positive for CD19, CD34, CD10(bright), CD22, HLA-DR, and CD58; and negative for CD20, CD117, CD13, CD33, and surface light chains.   This immunophenotype is typical for B lymphoblastic leukemia (B-ALL).

B-cell-ALL-flow-cytometry
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Serial flow of rapid WBC rise.

Increase in B Lymphoblastic Leukemia blast population in peripheral blood over 72 hours

B-cell-ALL-serial-flow-during-rapid-WBC-rise
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