Figure 4. Bone marrow core biopsy at low power (100x) magnification (A) and high power (1000x) magnification (B) revealed hypercellular marrow with a myeloid-to-erythroid ratio of at least 5:1, a marked decrease in megakaryocytes (near absent) and approximately 30% polytypic plasma cells.

No overt malignancy, blasts, or dysplasia was identified. The marked increase in the myeloid-to-erythroid ratio represented a reactive condition due to the patient’s critical medical condition and infections.