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Peripheral blood response to G-CSF

View larger version (141K): [in this window] [in a new window]   Figure 1. A Wright stained peripheral smear from a patient with multiple myeloma who was to undergo autologous bone marrow transplant using CD34+ peripheral stem cells is shown. The patient had been treated with prednisone and G-CSF. Although the majority of cells in this view are terminally differentiated bands and PMNs, a spectrum of myeloid maturation is noted including a blast cell. A subgroup of cells in this field has the morphologic appearance of monocytes and monocytoid precursors.

View larger version (154K): [in this window] [in a new window]   Figure 2. Apparent monocytoid cells with cytoplasmic vacuolization, pale blue cytoplasm, and irregular nuclear contours are also evident in this view.

View larger version (138K): [in this window] [in a new window]   Figure 3. A higher magnification of the previous image is shown to better illustrate the monocytoid cells. Note also the prominent granularity in some of the PMNs and the Döhle body-like inclusions.

View larger version (136K): [in this window] [in a new window]   Figure 4. Note in this view that the cytoplasm of the PMN in the upper half of the image is vacuolated. A more typical monocytoid cell is noted on the right. A myelocyte is also present.

View larger version (150K): [in this window] [in a new window]   Figure 5. This view shows the more characteristic immature myeloid cell findings post prednisone and G-CSF therapy with a blast and promyelocyte noted. In addition, the granules of the PMNs are very prominent and have a marked azurophilic tint.

View larger version (142K): [in this window] [in a new window]   Figure 6. A myeloperoxidase histochemical stain (gold staining of the cytoplasm) of the peripheral smear shows the majority of cells to be myeloid in origin including many that had a monocytoid appearance on the Wright stain.

View larger version (169K): [in this window] [in a new window]   Figure 7. A dual esterase histochemical stain (chloroacetate esterase for myeloid cell and butyrate esterase for monocytoid cells) confirms what was seen on the myeloperoxidase stain in that the majority of the cells stain positive (magenta) for myeloid origin. A single cell in the center of this view is positive (black) for monocytoid origin (arrow).

View larger version (141K): [in this window] [in a new window]   Figure 8. The previous image is shown at higher magnification more clearly illustrates the myeloid (magenta) and moncyoid (black) cells.

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This Article Figures Only Services Similar articles in this journal Alert me to new content in the Image Bank Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Lazarchick, J. Search for Related Content PubMed Articles by Lazarchick, J. Related Collections Effect of G-CSF, GM-CSF Related ASH-SAP Chapter Related Image Bank Image Sets Related ASH Education Book Article Social Bookmarking                   What's this?