Which of the following cells is typically seen with increased alkaline phosphatase activity in CML?

In Chronic Myeloid Leukemia (CML), an increase in alkaline phosphatase activity is typically associated with neutrophils. This is due to the fact that CML is characterized by an increase in myeloid cells, particularly granulocytes, as the disease progresses. Neutrophils, being predominant in this condition, display heightened enzyme activity, including alkaline phosphatase, which is often utilized as a marker of neutrophilic activation and differentiation.

The increase in alkaline phosphatase can be linked to the maturation of neutrophils that occurs as the disease advances, reflecting their functional activity. Elevated alkaline phosphatase levels are not a characteristic finding in monocytes, agranulocytes, or thrombocytes in the context of CML, making neutrophils the appropriate choice in this case. Thus, when evaluating patients with CML, the presence of neutrophils with increased alkaline phosphatase activity can serve as an important diagnostic feature, helping to confirm the diagnosis and understand the state of the disease.