PMC5329816_01
Bone marrow smear shows typical chronic
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Auxiliary examinations: blood routine test: white blood cell count (WBC) 8.2*10E9/L, red blood cell count (RBC) 2.84*10E12/L, hemoglobin (Hb) 92g/L, mean corpuscular hemoglobin concentration (MCHC) 382g/L, platelet count (PLT) 327*10E9/L, proportion of reticulocyte 10.1%; blood smear shows the proportion of spherocytes is 18%; Erythrocyte osmotic fragility test: hemolysis begins at 0.56% salt solution (normal control at 0.42%), complete hemolysis at 0.41% salt solution (normal control at 0.22%); liver function tests: total bilirubin (TB) 163.3umol/L, indirect bilirubin (IB) 154.4umol/L, Lactate dehydrogenase (LDH) 402U/L. computed tomography of the abdomen shows splenomegaly (7 rib units); bone marrow routine test shows significantly active bone marrow proliferation (Figure 1), erythroid proliferation is active, spherocytes are commonly seen, counts for 15%, folic acid, vitamin B12, ferritin, glucose phosphate isomerase, glucose-6-phosphate dehydrogenase test and pyruvate kinase tests were normal, Coomb's test shows negative result; normal hemoglobin electrophoresis; expression of CD55 and CD59 on erythrocytes and granulocytes are not significantly below normal range.
Typical chronic myeloid leukemia chromosome changes46, XX, t (9; 22) (q34; q11)
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Chromosome: 46, XX, t(9; 22)(q34; q11) (Figure 2); bone marrow gene test: M-bcr-abl/abl 92%, m-bcr-abl/abl(-).