{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T05:59:02Z","timestamp":1770789542366,"version":"3.50.0"},"reference-count":30,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2005,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Toxic insult to the bone marrow may result in partial or complete suppression, with or without reactive changes, and probable eventual regeneration of hematopoietic elements. During the regenerative process, increased blasts may be observed. Distinguishing these changes from an acute leukemic process can be difficult. In particular, the diagnosis of hypocellular bone marrow with increased blasts, also known as hypocellular or hypoplastic acute leukemia, presents a diagnostic dilemma for pathologists. We report a case of hypocellular marrow with increased blasts in a 50-year-old man with an extensive history of alcohol and drug abuse in whom chemotherapy was deferred. Recovery of peripheral blood cell counts and reticulocytosis occurred with withdrawal of the offending agents, and he remains alive and well 1 year later.<\/jats:p>","DOI":"10.5858\/2005-129-e35-ibmali","type":"journal-article","created":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T19:01:02Z","timestamp":1612983662000},"page":"e35-e38","source":"Crossref","is-referenced-by-count":5,"title":["Increased Blasts Mimicking Acute Leukemia in a Patient With Polysubstance Abuse"],"prefix":"10.5858","volume":"129","author":[{"given":"Michelle","family":"Bianco","sequence":"first","affiliation":[{"name":"From the Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City (Drs Bianco and Rosenthal); and New Hanover Regional Medical Center, Wilmington, NC (Dr Turner)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Turner","sequence":"additional","affiliation":[{"name":"From the Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City (Drs Bianco and Rosenthal); and New Hanover Regional Medical Center, Wilmington, NC (Dr Turner)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"From the Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City (Drs Bianco and Rosenthal); and New Hanover Regional Medical Center, Wilmington, NC (Dr Turner)"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3906","reference":[{"key":"i1543-2165-129-2-e35-b1","article-title":"Acute myeloid leukemia.","author":"Brunning, R. D.","unstructured":"Brunning, R. D., E.Matutes, and N. L.Harris. et al. Acute myeloid leukemia.In: Jaffe ES, Harris NL, Stein H, Vardiman J, eds. Pathology and Genetics of Tumours of Haematopoietic and Lymphoid Tissues. Lyon, France: IARC Press; 2001:76\u2013107. World Health Organization Classification of Tumours; vol 3."},{"key":"i1543-2165-129-2-e35-b2","series-title":"Semin Hematol","first-page":"164","article-title":"Hematologic complications of alcoholism: overview.","volume":"17","author":"Colman, N.","year":"1980","unstructured":"Colman, N. and V.Herbert. Hematologic complications of alcoholism: overview.Semin Hematol1980. 17:164\u2013176."},{"key":"i1543-2165-129-2-e35-b3","series-title":"Am J Med","first-page":"621","article-title":"The hematologic disorders of alcoholism.","volume":"54","author":"Eichner, E. R.","year":"1973","unstructured":"Eichner, E. R.\n          \n          The hematologic disorders of alcoholism.\n          Am J Med\n          1973. 54:621\u2013630."},{"key":"i1543-2165-129-2-e35-b4","series-title":"Acta Haematol","first-page":"252","article-title":"Alcohol-induced bone marrow damage: a bone marrow study in alcohol-dependent individuals.","volume":"78","author":"Michot, F.","year":"1987","unstructured":"Michot, F. and J.Gut. Alcohol-induced bone marrow damage: a bone marrow study in alcohol-dependent individuals.Acta Haematol1987. 78:252\u2013257."},{"key":"i1543-2165-129-2-e35-b5","series-title":"Semin Hematol","first-page":"130","article-title":"Effects of alcohol on granulocytes and lymphocytes.","volume":"17","author":"Liu, Y. K.","year":"1980","unstructured":"Liu, Y. K.\n          \n          Effects of alcohol on granulocytes and lymphocytes.\n          Semin Hematol\n          1980. 17:130\u2013136."},{"key":"i1543-2165-129-2-e35-b6","series-title":"J Pediatr Hematol Oncol","first-page":"62","article-title":"Hematologic toxicity of sodium valproate.","volume":"22","author":"Acharya, S.","year":"2000","unstructured":"Acharya, S. and J. B.Bussel. Hematologic toxicity of sodium valproate.J Pediatr Hematol Oncol2000. 22:62\u201365."},{"key":"i1543-2165-129-2-e35-b7","series-title":"J Pediatr Hematol Oncol","first-page":"73","article-title":"Trilineage hematopoietic toxicity associated with valproic acid therapy.","volume":"19","author":"Bottom, K. S.","year":"1997","unstructured":"Bottom, K. S., D. M.Adams, K. P.Mann, and R. E.Ware. Trilineage hematopoietic toxicity associated with valproic acid therapy.J Pediatr Hematol Oncol1997. 19:73\u201376."},{"key":"i1543-2165-129-2-e35-b8","series-title":"N Engl J Med","first-page":"1003","article-title":"Hypoplastic anemia and myeloblastic leukemia following chloramphenicol therapy: report of three cases.","volume":"277","author":"Brauer, M. J.","year":"1967","unstructured":"Brauer, M. J. and W.Dameshek. Hypoplastic anemia and myeloblastic leukemia following chloramphenicol therapy: report of three cases.N Engl J Med1967. 277:1003\u20131005."},{"key":"i1543-2165-129-2-e35-b9","series-title":"Hematol Pathol","first-page":"95","article-title":"Bone marrow morphology during induction phase of therapy for acute myeloid leukemia (AML).","volume":"9","author":"Dick, F. R.","year":"1995","unstructured":"Dick, F. R., C. P.Burns, G. J.Weiner, and K. D.Heckman. Bone marrow morphology during induction phase of therapy for acute myeloid leukemia (AML).Hematol Pathol1995. 9:95\u2013106."},{"key":"i1543-2165-129-2-e35-b10","series-title":"Am J Clin Pathol","first-page":"675","article-title":"Transient increase in blasts mimicking acute leukemia and progressing myelodysplasia in patients receiving growth factor.","volume":"109","author":"Meyerson, H. J.","year":"1998","unstructured":"Meyerson, H. J., D. C.Farhi, and N. S.Rosenthal. Transient increase in blasts mimicking acute leukemia and progressing myelodysplasia in patients receiving growth factor.Am J Clin Pathol1998. 109:675\u2013681."},{"key":"i1543-2165-129-2-e35-b11","series-title":"Am J Med","first-page":"391","article-title":"Hypocellular acute leukemia.","volume":"72","author":"Howe, R. B.","year":"1982","unstructured":"Howe, R. B., C. D.Bloomfield, and R. W.McKenna. Hypocellular acute leukemia.Am J Med1982. 72:391\u2013395."},{"key":"i1543-2165-129-2-e35-b12","series-title":"Hematol Oncol","first-page":"291","article-title":"Hypoplastic acute leukemia: review of 70 cases with multivariate regression analysis.","volume":"4","author":"Berdeaux, D. H.","year":"1986","unstructured":"Berdeaux, D. H., L.Glasser, R.Serokmann, T.Moon, and B. G.Durie. Hypoplastic acute leukemia: review of 70 cases with multivariate regression analysis.Hematol Oncol1986. 4:291\u2013305."},{"key":"i1543-2165-129-2-e35-b13","series-title":"Hematol Pathol","first-page":"195","article-title":"Hypocellular acute myeloid leukemia: the Rochester (New York) experience.","volume":"9","author":"Tuzuner, N.","year":"1995","unstructured":"Tuzuner, N., C.Cox, J. M.Rowe, and J. M.Bennett. Hypocellular acute myeloid leukemia: the Rochester (New York) experience.Hematol Pathol1995. 9:195\u2013203."},{"key":"i1543-2165-129-2-e35-b14","series-title":"Leuk Res","first-page":"563","article-title":"Diagnostic criteria for hypocellular acute leukemia: a clinical entity distinct from overt acute leukemia and myelodysplastic syndrome.","volume":"20","author":"Nagai, K.","year":"1996","unstructured":"Nagai, K., T.Kohno, and Y. X.Chen. et al. Diagnostic criteria for hypocellular acute leukemia: a clinical entity distinct from overt acute leukemia and myelodysplastic syndrome.Leuk Res1996. 20:563\u2013574."},{"key":"i1543-2165-129-2-e35-b15","series-title":"Am J Hematol","first-page":"15","article-title":"Hypocellular bone marrow with increased blasts.","volume":"21","author":"Gladson, C. L.","year":"1986","unstructured":"Gladson, C. L. and F.Naeim. Hypocellular bone marrow with increased blasts.Am J Hematol1986. 21:15\u201322."},{"key":"i1543-2165-129-2-e35-b1","article-title":"Acute myeloid leukemia.","author":"Brunning, R. D.","unstructured":"Brunning, R. D., E.Matutes, and N. L.Harris. et al. Acute myeloid leukemia.In: Jaffe ES, Harris NL, Stein H, Vardiman J, eds. Pathology and Genetics of Tumours of Haematopoietic and Lymphoid Tissues. Lyon, France: IARC Press; 2001:76\u2013107. World Health Organization Classification of Tumours; vol 3."},{"key":"i1543-2165-129-2-e35-b2","series-title":"Semin Hematol","first-page":"164","article-title":"Hematologic complications of alcoholism: overview.","volume":"17","author":"Colman, N.","year":"1980","unstructured":"Colman, N. and V.Herbert. Hematologic complications of alcoholism: overview.Semin Hematol1980. 17:164\u2013176."},{"key":"i1543-2165-129-2-e35-b3","series-title":"Am J Med","first-page":"621","article-title":"The hematologic disorders of alcoholism.","volume":"54","author":"Eichner, E. R.","year":"1973","unstructured":"Eichner, E. R.\n          \n          The hematologic disorders of alcoholism.\n          Am J Med\n          1973. 54:621\u2013630."},{"key":"i1543-2165-129-2-e35-b4","series-title":"Acta Haematol","first-page":"252","article-title":"Alcohol-induced bone marrow damage: a bone marrow study in alcohol-dependent individuals.","volume":"78","author":"Michot, F.","year":"1987","unstructured":"Michot, F. and J.Gut. Alcohol-induced bone marrow damage: a bone marrow study in alcohol-dependent individuals.Acta Haematol1987. 78:252\u2013257."},{"key":"i1543-2165-129-2-e35-b5","series-title":"Semin Hematol","first-page":"130","article-title":"Effects of alcohol on granulocytes and lymphocytes.","volume":"17","author":"Liu, Y. K.","year":"1980","unstructured":"Liu, Y. K.\n          \n          Effects of alcohol on granulocytes and lymphocytes.\n          Semin Hematol\n          1980. 17:130\u2013136."},{"key":"i1543-2165-129-2-e35-b6","series-title":"J Pediatr Hematol Oncol","first-page":"62","article-title":"Hematologic toxicity of sodium valproate.","volume":"22","author":"Acharya, S.","year":"2000","unstructured":"Acharya, S. and J. B.Bussel. Hematologic toxicity of sodium valproate.J Pediatr Hematol Oncol2000. 22:62\u201365."},{"key":"i1543-2165-129-2-e35-b7","series-title":"J Pediatr Hematol Oncol","first-page":"73","article-title":"Trilineage hematopoietic toxicity associated with valproic acid therapy.","volume":"19","author":"Bottom, K. S.","year":"1997","unstructured":"Bottom, K. S., D. M.Adams, K. P.Mann, and R. E.Ware. Trilineage hematopoietic toxicity associated with valproic acid therapy.J Pediatr Hematol Oncol1997. 19:73\u201376."},{"key":"i1543-2165-129-2-e35-b8","series-title":"N Engl J Med","first-page":"1003","article-title":"Hypoplastic anemia and myeloblastic leukemia following chloramphenicol therapy: report of three cases.","volume":"277","author":"Brauer, M. J.","year":"1967","unstructured":"Brauer, M. J. and W.Dameshek. Hypoplastic anemia and myeloblastic leukemia following chloramphenicol therapy: report of three cases.N Engl J Med1967. 277:1003\u20131005."},{"key":"i1543-2165-129-2-e35-b9","series-title":"Hematol Pathol","first-page":"95","article-title":"Bone marrow morphology during induction phase of therapy for acute myeloid leukemia (AML).","volume":"9","author":"Dick, F. R.","year":"1995","unstructured":"Dick, F. R., C. P.Burns, G. J.Weiner, and K. D.Heckman. Bone marrow morphology during induction phase of therapy for acute myeloid leukemia (AML).Hematol Pathol1995. 9:95\u2013106."},{"key":"i1543-2165-129-2-e35-b10","series-title":"Am J Clin Pathol","first-page":"675","article-title":"Transient increase in blasts mimicking acute leukemia and progressing myelodysplasia in patients receiving growth factor.","volume":"109","author":"Meyerson, H. J.","year":"1998","unstructured":"Meyerson, H. J., D. C.Farhi, and N. S.Rosenthal. Transient increase in blasts mimicking acute leukemia and progressing myelodysplasia in patients receiving growth factor.Am J Clin Pathol1998. 109:675\u2013681."},{"key":"i1543-2165-129-2-e35-b11","series-title":"Am J Med","first-page":"391","article-title":"Hypocellular acute leukemia.","volume":"72","author":"Howe, R. B.","year":"1982","unstructured":"Howe, R. B., C. D.Bloomfield, and R. W.McKenna. Hypocellular acute leukemia.Am J Med1982. 72:391\u2013395."},{"key":"i1543-2165-129-2-e35-b12","series-title":"Hematol Oncol","first-page":"291","article-title":"Hypoplastic acute leukemia: review of 70 cases with multivariate regression analysis.","volume":"4","author":"Berdeaux, D. H.","year":"1986","unstructured":"Berdeaux, D. H., L.Glasser, R.Serokmann, T.Moon, and B. G.Durie. Hypoplastic acute leukemia: review of 70 cases with multivariate regression analysis.Hematol Oncol1986. 4:291\u2013305."},{"key":"i1543-2165-129-2-e35-b13","series-title":"Hematol Pathol","first-page":"195","article-title":"Hypocellular acute myeloid leukemia: the Rochester (New York) experience.","volume":"9","author":"Tuzuner, N.","year":"1995","unstructured":"Tuzuner, N., C.Cox, J. M.Rowe, and J. M.Bennett. Hypocellular acute myeloid leukemia: the Rochester (New York) experience.Hematol Pathol1995. 9:195\u2013203."},{"key":"i1543-2165-129-2-e35-b14","series-title":"Leuk Res","first-page":"563","article-title":"Diagnostic criteria for hypocellular acute leukemia: a clinical entity distinct from overt acute leukemia and myelodysplastic syndrome.","volume":"20","author":"Nagai, K.","year":"1996","unstructured":"Nagai, K., T.Kohno, and Y. X.Chen. et al. Diagnostic criteria for hypocellular acute leukemia: a clinical entity distinct from overt acute leukemia and myelodysplastic syndrome.Leuk Res1996. 20:563\u2013574."},{"key":"i1543-2165-129-2-e35-b15","series-title":"Am J Hematol","first-page":"15","article-title":"Hypocellular bone marrow with increased blasts.","volume":"21","author":"Gladson, C. L.","year":"1986","unstructured":"Gladson, C. L. and F.Naeim. Hypocellular bone marrow with increased blasts.Am J Hematol1986. 21:15\u201322."}],"container-title":["Archives of Pathology &amp; Laboratory Medicine"],"original-title":[],"link":[{"URL":"https:\/\/aplm.kglmeridian.com\/view\/journals\/arpa\/129\/2\/article-pe35.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/meridian.allenpress.com\/aplm\/article-pdf\/129\/2\/e35\/2755903\/1543-2165(2005)129_e35_ibmali_2_0_co_2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/aplm.kglmeridian.com\/downloadpdf\/journals\/arpa\/129\/2\/article-pe35.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/aplm.kglmeridian.com\/downloadpdf\/journals\/arpa\/129\/2\/article-pe35.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T01:12:17Z","timestamp":1770772337000},"score":1,"resource":{"primary":{"URL":"https:\/\/aplm.kglmeridian.com\/view\/journals\/arpa\/129\/2\/article-pe35.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,2]]},"references-count":30,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.5858\/2005-129-e35-ibmali","relation":{},"ISSN":["1543-2165","0003-9985"],"issn-type":[{"value":"1543-2165","type":"electronic"},{"value":"0003-9985","type":"print"}],"subject":[],"published":{"date-parts":[[2005,2]]}}}