Article Figures & Data
Figures
- Figure 1
The peripheral blood smear shows giant platelets highlighted in black circles (hematoxylin and eosin, magnification × 400).
- Figure 2
Bone marrow biopsy shows increased megakaryopoiesis indicated by black arrows at magnification × 200 (panel A) and at magnification × 400 (panel B).
- Figure 3
Trend in platelet counts and treatment interventions implemented to manage thrombocytopenia over a period of 7 months.
Tables
- TABLE 1
Laboratory values for a 35-year-old woman who underwent simultaneous pancreas and kidney transplant and developed chronic myeloid leukemia
Laboratory parameters (reference range) Pretransplant 1 week after transplant Thrombocytopenia admission (about 6.5 years after transplant Bicytopenic cycle (2 weeks after the thrombocytopenia admission) White blood cell count (4–10 × 109/L) 20 80 6 7 Hemoglobin (12–16 g/dL) 10.6 9.5 11 7.8 Platelet count (150–400 × 109/L) 281 440 6 20 Reticulocyte count (0.5%–1.5%) NA NA 2.1% 16.3% Neutrophils (1.5–8 × 109/L) 15 29 4.4 5.3 Lymphocytes (1–5 × 109/L) 3.5 3 1.3 1.5 Eosinophils (0–0.5 × 109/L) 0.4 0.8 0.2 0.2 Basophils (0–0.2 × 109/L) 0.2 0.8 0.1 0.1 Metamyelocytes (0%–1%) 2% 11% NA NA Myelocytes (0%) 2% 1% NA NA Promyelocytes (0%) 2% NA NA NA Peripheral blood smear NA Normocytic hypochromic anemia with anisopoikilocytosis, slight polychromasia, a few burr cells, leukocytosis with reactive polymorphonuclear leukocytes and left shift
No blasts were seenNormochromic normocytic anemia with slight polychromasia
No increase in schistocytes
Marked thrombocytopenia with a few large formsNormocytic anemia with increased polychromasia, increased microspherocytes
No significant schistocytes or blasts
Platelets showed normal morphology without clumpingProthrombin time (10–13 seconds) 13 17.3 13 12.3 International normalized ratio (0.8–1.1) 1.05 1.3 1 0.9 Partial thromboplastin time (25–35 seconds) 34 45 27 23 Fibrinogen (200–400 mg/dL) NA NA 367 NA NA = not available
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