American Society for Clinical Pathology (ASCP) Technologist in Cytogenetics certification (ASCP CG) Practice Test

In the classification of AML types, what does a lack of differentiation suggest?

1. Potential for increased cell proliferation

2. Improved treatment outcomes

3. Association with more severe chromosomal abnormalities

4. Direct correlation with mature cell types

The correct answer is: Potential for increased cell proliferation

A lack of differentiation in acute myeloid leukemia (AML) generally indicates that the leukemic cells have not matured properly and are displaying features typical of earlier stages of cell development. This immature state can suggest a potential for increased cell proliferation because these cells often have a greater capacity to divide rapidly, which is a hallmark of aggressive malignancies like AML. When cells do not differentiate and remain in an undifferentiated state, they may also evade normal regulatory mechanisms that control cell growth and death, leading to uncontrolled proliferation. This characteristic is significant when evaluating the aggressiveness and potential behavior of the leukemia. The other options do not align with what a lack of differentiation suggests in the context of AML. Improved treatment outcomes typically associate with more differentiated, mature cells, while severe chromosomal abnormalities are more often linked to specific types of AML with marked differentiation challenges. Finally, a direct correlation with mature cell types would suggest that the cells can become more similar to normal cells, contradicting the premise of a lack of differentiation. Thus, recognizing that increased cell proliferation is a primary concern with undifferentiated AML helps clarify the implications of cell differentiation status in this particular context.