Is the blood smear okay to rule out leukemia?

A blood smear is important in diagnosing leukemia, but a single blood smear does not completely rule out leukemia. If leukemia is suspected, it is recommended to seek medical attention in time to complete other relevant examinations.

1. Circumstances that can be excluded

If the blood count shows no naïve cells or myelocytes, acute myeloid leukemia can be ruled out. In addition, in the case of chronic lymphocytic leukemia, a large number of mature B lymphocytes can be seen on the bone marrow smear, and there are no blasts and naïve cells.

2. Circumstances that cannot be excluded

1. Acute myeloid leukemia: This disease is a malignant clonal disease of hematopoietic stem cells, which is caused by inhibition of normal hematopoiesis and infiltration of other tissues and organs due to a variety of reasons. Clinically, according to the pathogenesis and morphological characteristics, it can be divided into 8 types: M0-M7. Among them, M4 type is promyelocytic leukemia, which is characterized by a large number of abnormal promyelocytes in the bone marrow, while naïve myelocytes are the main in peripheral blood;

2. Chronic lymphocytic leukemia: It is an indolent B lymphocytic tumor, which is mainly manifested as anemia, bleeding tendency and hepatosplenomegaly. Bone marrow aspirate showed a decrease in erythrocytes, granulocytes, and megakaryocytes, significant lymph node proliferation, and a large number of mature B lymphocytes in peripheral blood.

When a blood smear does not reveal any abnormalities, it does not mean that leukemia or other blood disorders are not present. In order to confirm the diagnosis, further karyotyping, immunophenotyping and other related tests are recommended.