AMCmiddle twist
A 29-year-old man presents with fever, bruising and aching in the long bones. He has pallor, scattered petechiae and a spleen palpable 2 cm below the costal margin. His haemoglobin is 76 g/L (135–180), platelet count 24 × 10^9/L (150–400) and white cell count 38 × 10^9/L (4–11). The blood film contains numerous blasts, some with slender azurophilic cytoplasmic inclusions, but no previous abnormal blood counts are available. Which one of the following is the most likely diagnosis?