American Board of Internal Medicine (ABIM) Certification Practice Exam

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What is the minimum percentage of blast forms required for a diagnosis of Acute Myeloid Leukemia (AML)?

10 percent
15 percent
20 percent
25 percent

The correct answer is: 20 percent

A diagnosis of Acute Myeloid Leukemia (AML) requires a minimum of 20 percent blast forms in the bone marrow or peripheral blood. This threshold is essential because it helps differentiate AML from other hematological conditions where an elevated blast count may be observed but does not meet the criteria for leukemia. Blast cells are immature blood cells, and their presence in significant numbers indicates an abnormal hematopoietic process. When the percentage of these cells is equal to or exceeds 20 percent, it suggests a pathological proliferation of myeloid lineage cells, which is characteristic of AML. This criterion is part of the World Health Organization (WHO) classification, which standardized diagnostic criteria to ensure accurate diagnosis and treatment planning. A lower percentage, such as 10 or 15 percent, is not sufficient for the diagnosis of AML, as these levels may occur in other conditions, such as reactive bone marrow changes or anemia. Thus, the requirement of 20 percent ensures that only those with a clear diagnosis of AML are classified as such, which is crucial for appropriate clinical management.