| Erythroid Lineage | Myeloid Lineage | Megakaryocyte Lineage | |
|---|---|---|---|
| Bone Marrow Aspirateb | Dysplasia and/or megablastoid changes in ≥10% of erythroid precursorsc | Dysplasia in ≥10% of granulocytic precursors and neutrophils | Micromegakaryocytes plus other dysplastic featurese |
| <5% blastsd | |||
| Bone Marrow Biopsy | Presence of erythroid precursors | No additional criteria | Micromegakaryocytes plus other dysplastic featurese |
| Increased proerythroblasts | Immunohistochemistry positive for CD61 and CD41 | ||
| Increased number of mitoses | |||
| Peripheral Blood | Dysplasia in ≥10% of neutrophils | ||
| <2% blasts | |||
aAdapted from Baumann et al.[34]
bBone marrow trephine/biopsy may be required as bone marrow in childhood RCC is often hypocellular.
cCharacteristics include abnormal nuclear lobulation, multinuclear cells, presence of nuclear bridges.
dPresence of pseudo–Pelger-Huet cells, hypo- or agranular cytoplasm, giant band forms.
eMegakaryocytes have variable size and often round or separated nuclei; the absence of megakaryocytes does not exclude the diagnosis of RCC.
From: Childhood Acute Myeloid Leukemia/Other Myeloid Malignancies Treatment (PDQ®)
NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.