This week’s Morphology Monday case centres on a patient who presented with a gastrointestinal (GI) bleed and was started on tranexamic acid (TXA) as part of their management.

During admission, a full blood count was performed and showed the following results:

• WBC: 61.84 ×10⁹/L
• Hb: 95 g/L
• Platelets: 14 ×10⁹/L

Given the combination of marked leukocytosis, anaemia, and profound thrombocytopaenia, a blood film was urgently reviewed. Clinical context and analyser flags raised concern for an underlying haematological issue

Peripheral blood film images

What do you think is going on?