Acute leukemias are associated with all of the following EXCEPT:

The presence of smudge cells is typically associated with chronic lymphocytic leukemia (CLL) rather than acute leukemias. Smudge cells are remnants of leukemic cells that appear damaged during the preparation of blood smears, and they can be indicative of more chronic conditions.

Acute leukemias, on the other hand, are characterized by the rapid accumulation of immature white blood cells, known as leukemic cells, which leads to various hematological abnormalities. Common features of acute leukemias include anemia due to the crowding out of normal red blood cells, thrombocytopenia caused by inadequate platelet production, and the presence of immature leukocytes, which are a hallmark of these conditions.

Understanding these distinctions helps in recognizing the specific characteristics that define acute leukemias, making it clear why smudge cells do not belong to that category.