A 35-year-old woman presents with increased bruising. On exam, she is noted to have extensive ecchymosis. Laboratory testing shows a markedly elevated international normalized ratio (INR) and activated partial thromboplastin time (aPTT), platelet count of 15,000/µL, and a fibrinogen level of 35 mg/dL. The hematocrit is low at 21% and the total white blood cell count is only 2000 cells/µL. Rare blasts are noted on the blood smear.