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Laboratory evaluation disclosed leukocytosis of 88.5 x 103/uL (normal 4.8-10.8 x 103/uL) with 24.0% monocytes on differential, creatinine 2.94 mg/dL (baseline creatinine 1.7-1.9 mg/dL), uric-acid 19.8 mg/dL, potassium 4.0 mmol/L, phosphorus 4.0 mg/dL, calcium 9.2 mg/dL, and albumin 3.2 g/dL. Urinalysis had been significant for protein 200 mg/dL, 20/LPF granular casts, and 7/LPF hyaline casts. Bone marrow biopsy disclosed 20-30% blasts with monocytic popular features of differentiation in li
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