A 47-year-old man comes to the office due to 2 days of
sore throat, purulent nasal discharge and facial pain. Past medical history is significant for several
sinus infections over the past 6 months, all of which resolved with oral antibiotics. Temperature is 38.5°C (101.4°F),
pulse is 80/minute, respirations are 19/minute, and
blood pressure is 130/70 mmHg. Physical examination shows pharyngeal erythema and
maxillary sinus tenderness. There is no
lymphadenopathy. Laboratory results are as follows:
| Laboratory value | Result |
| Complete blood count |
| Hemoglobin | 10 g/dL |
| Platelets | 600,000/mm3 |
| Leukocytes | 100,100/mm3 |
| Neutrophils | 40% |
| Myelocytes | 32% |
| Metamyelocytes | 10% |
| Band forms | 1% |
| Blast cells | 1% |
| Lymphocytes | 7% |
Fluorescence in situ hybridization (FISH) analysis reveals a bcr-abl fusion gene. Which of the following additional findings is most likely to be seen in this patient?
