Blood Health
Absolute Prolymphocytes
What This Marker Tells Us
Measures the most immature neutrophil precursors (four stages before maturity); their presence nearly always indicates leukemia or life-threatening infection requiring emergency evaluation.
Why It Matters
Promyelocytes are extremely immature neutrophil precursors normally found only deep in bone marrow. Their appearance in peripheral blood is always pathological, most commonly indicating acute promyelocytic leukemia (APL), other acute leukemias, or overwhelming sepsis. These abnormal promyelocytes can cause life-threatening bleeding through disseminated intravascular coagulation (DIC). Any circulating promyelocytes require immediate hematologic evaluation, peripheral blood smear review, and often emergency treatment. Even one promyelocyte warrants urgent attention. The presence of promyelocytes alongside other blasts helps diagnose specific leukemia types and guides treatment.
How to Interpret Your Trends
Normal promyelocytes in peripheral blood: 0 cells/μL (0%). Any detectable promyelocytes are critically abnormal. Even a single promyelocyte demands immediate medical evaluation and hematology consultation. Promyelocytes above 1-2% strongly suggest acute leukemia, most commonly acute promyelocytic leukemia. High promyelocyte counts (above 5-10%) with bleeding tendencies indicate APL emergency requiring immediate treatment with all-trans retinoic acid (ATRA) to prevent fatal hemorrhage.
What Influences This Marker
Promyelocytes appear almost exclusively with acute leukemias (especially acute promyelocytic leukemia), occasionally with severe sepsis or toxic exposures, and rarely with G-CSF administration. Unlike bands or metamyelocytes which may appear transiently with infection, promyelocytes nearly always indicate malignancy. Any promyelocytes require emergency hematologic evaluation, bone marrow biopsy, and genetic testing to diagnose leukemia type and guide treatment.
How Your Team Uses It
Your coach recognizes promyelocytes as a medical emergency beyond coaching scope. Their immediate role is ensuring you seek emergency medical care, then supporting treatment adherence, rest, nutrition during chemotherapy, and infection prevention during immune suppression.
Related Signals We Also Review
Blasts, myelocytes, metamyelocytes, platelet count (often low in APL), coagulation studies (APL causes DIC), peripheral blood smear, bone marrow biopsy, and emergency hematology consultation.