case_images: PMC10624022_01
case_images: (A) Bone marrow core biopsy (H&E, 40x) demonstrating packed bone marrow with 85% to 90% blasts, absent erythroids and megakaryocytes, consistent with relapsed CML-BC. (B) Immunohistochemistry with blast cells staining positive for CD34.. Abbreviation: CML-BC, chronic myeloid leukemia with blast crisis.
case_images: 10.1177_23247096231209543-fig1.jpg
case_images: PMC10624022_01_10.1177_23247096231209543-fig1.jpg
case_images: fig1-23247096231209543
case_images: Bone marrow aspirate and core biopsy performed on hospital day 3 revealed nearly 100% cellular marrow with absent erythroids and megakaryocytes, 85% to 90% blasts, consistent with relapse of CML-BC (Figure 1).
case_images: Line graph demonstrating INR, peripheral blast percentage, and FVII level during hospitalization. Following administration of chemotherapy, INR and blast count decreased, while FVII level increased.. Abbreviations: FVII, Factor VII; INR, internationalized normal ratio.
case_images: 10.1177_23247096231209543-fig2.jpg
case_images: PMC10624022_01_10.1177_23247096231209543-fig2.jpg
case_images: fig2-23247096231209543
case_images: Internationalized normal ratio increased rapidly from 1.6 on admission to 4.1 on hospital day 2, corresponding with an increase in peripheral blast count (Figure 2). The coagulopathy rapidly improved after initiation of chemotherapy and correlated with decline in peripheral blast count (Figure 2).