Dysplastic peripheral blood polymorphs link acute myeloblastic leukaemia in elderly to the mvelodvsdastic Syndromes

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Abstract
We studied dysplastic features in peripheral blood polymorphs from 80 patients with acute leukaemia. Thirty‐seven patients with de novo acute myeloblastic leukaemia (AML) were compared to 26 patients with AML that had developed after a myelodysplastic phase (MDS‐AML), and 17 cases of acute lymphoblastic leukaemia (ALL). Cytoplasmic hypogranulation in neutrophils, measured as a score value (G‐score; normal range: 255–300), and the percentage of pelgeroid polymorphs (ppp; normal range: 0–5%) were studied retrospectively by reviewing the diagnostic peripheral blood smears. The mean G‐score was decreased in MDS‐AML (178 ± 67.9), and in de novo AML (212 f 65.l), but not in ALL (275 ± 24.3). When de now AML patients were divided by age, the elderly (> 60 yr) had significantly (p = 0.0001) lower mean G‐score than the younger (de now AML patients also had significantly (p = 0.0057) higher mean ppp. By studying the degree of polymorph dysplasia in the peripheral blood, it seems possible to identify a subset of dysplastic elderly AML patients, who might have passed a (preleukaemic) MDS phase unnoticed.