The cells were initally interpreted by an outside lab as being mature lymphocytes, associated with a low grade lymphoproliferative lesion. However, flow cytometry studies suggested these cells to be blasts, CD33/CD34 positive. The patient further demonstrated signs of anemia (low red blood cells), and thrombocytopenia (low platelets), which tend not to be associated with a low grade lymphoproliferative disorder like Chronic lymphocytic leukemia (CLL). It is believed because of the number of blasts present in the peripheral blood that this is an example of acute leukemia arising in a background of myelodysplasia (preleukemia) now progressing to acute leukemia. Cytogenetic studies would be required to confirm the diagnosis, in addition to bone marrow biopsy study.
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Children's Cancer Journal