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Blood Film

The Leukoerythroblastic Blood Film

March 4th, 2023


A leukoerythroblastic blood film refers to the presence of granulocyte left shift as well as nucleated red blood cells on the same blood film.
This is always an abnormal finding, and may indicate a major acute stress or bone marrow infiltration.
  • Look For

  • Left shift of granulocytes - the presence of increased band forms, metamyelocytes, myelocytes or sometimes promyelocytes
  • Nucleated red blood cells - immature red cells which have not yet extruded their nuclei
  • Causes of a Leukoerythroblastic Blood Film

  • Acute stress - haemorrhage, shock
  • Bone marrow infiltration - myeloproliferative neoplasms, leukaemias, lymphomas, myeloma, metastatic cancer
  • G-CSF administration
  • Examples

  • A myelocyte, demonstrating left shift.
  • A myelocyte, demonstrating left shift.
  • A nucleated red blood cell.
  • A nucleated red blood cell.
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