Blood picture of a 90-year-old woman treated for macroglobulinemia (morbus Waldenström) with chemotherapy (chlorambucil). After this treatment, aberrant neutrophils develop with a centrally located mature, round and condensed nucleus. The cells are large and have ample cytoplasm with strong granulation and döhle. This dysplasia is most likely due to chemotherapy AND her advanced age. There was no evidence of infection.