Representative peripheral blood and BM smears from patients with aCML, BCR-ABL 1 negative. (A) Peripheral blood smear showing leukocytosis. On the upper left is a metamyelocyte; lower left, a dysplastic neutrophil. May-Grünwald-Giemsa (MGG) staining; magnification, × 400. (B) Peripheral blood smear. A neutrophil with nuclear hypersegmentation (center) and a red cell with a Howell-Jolly body (top); left, polychromatic red cells and giant platelets. MGG staining; magnification, × 1250. (C) BM smear showing granuloblastic hyperplasia and erythroid hypoplasia. Mature neutrophils are agranular and show abnormal nuclear segmentation. Note the micromegakaryocyte (center). MGG staining; magnification, × 640. (D) Syndrome of abnormal chromatin clumping. Peripheral blood smear showing leukocytosis, immature granulocytes, and neutrophils with abnormal condensation of the nuclear chromatin. MGG staining; magnification, × 1250.