The leukocytopenic forms are the most difficult to differentiate from aplastic anemias, pancytopenias, and the myelodysplastic syndromes. Bone marrow aspiration is usually necessary to establish a diagnosis. Classication of acute leukemias according to morphologic criteria . Clinical Hematology, 3rd ed., Thieme, Stuttgart. Its clinical manifestations and course are basically identical to those of acute leukemia.
Auer rods are unusual.
Acute basophilic leukemia is evidenced by an extreme increase in the basophilic granulated cells of granulocytopoiesis. The diagnosis is confirmed by the metachromatic reaction to toluidine blue in the cells. The blast cells in the peripheral blood and bone marrow present a variety of morphologies. The nuclei are round, finely reticular, and have one to three prominent nucleoli. The cells vary greatly in size and may be two to three times larger than normal lymphocytes.