Letter to the Editor

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Blood Res 2014; 49(1):

Published online March 31, 2014

https://doi.org/10.5045/br.2014.49.1.69

© The Korean Society of Hematology

Pure erythroid leukemia in advanced breast cancer

Pasquale Niscola1*, Andrea Tendas1, Mauro Minelli2, Alessio Perrotti1, Paolo de Fabritiis1, and Giovanni Del Poeta1

1Hematology Division, S. Eugenio Hospital, Rome, Italy.

2Oncology Unit, S. Eugenio Hospital, Rome, Italy.

Correspondence to : Pasquale Niscola. Hematology Division, S. Eugenio Hospital, Piazzale dell'Umanesimo 10, 00144, Rome, Italy. pniscola@gmail.com

Received: November 20, 2013; Revised: January 6, 2014; Accepted: March 4, 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Fig. 1.

Bone marrow smears (×400, panoptical staining) showing several erythroblasts in different maturation phases with clear dyserythropoietic features (maturative asynchronism, cytoplasmic blebs). (A) A bone marrow smear revealed megaloblastoid proerythroblasts with polychromatophilic cytoplasm, multiple cytoplasmic blebs, and polylobated hyperdiploid nucleus with finely dense chromatin. (B) A bone marrow smear revealed giant proerythroblast with scarce basophilic cytoplasm and round nucleus with immature chromatin.


Fig. 2.

Bone marrow trephine biopsy at diagnosis of pure erythroid leukemia. (A) Medium magnification (×200) shows a predominant bone marrow population composed of atypical immature erythroid precursors (more than 90% with nucleated cells). (B) High magnification (×400) revealed numerous atypical erythroid precursors and dyserythropoiesis. (C) Glycophorin-A immunostain expressed by the atypical erythroid neoplastic precursors. (D) Linker for activated T-cells immunostain shows dysmegakaryocytopoiesis with a micromegakaryocytes and a population of immature megakaryoblasts.


  1. Wang, SA, Hasserjian, RP. Erythroid proliferations in myeloid neoplasms. Hum Pathol, 2012;43;153-164.
    Pubmed
  2. Liu, W, Hasserjian, RP, Hu, Y, et al. Pure erythroid leukemia: a reassessment of the entity using the 2008 World Health Organization classification. Mod Pathol, 2011;24;375-383.
    Pubmed
  3. Liu, CJ, Hong, YC, Yang, CF, et al. Clinicopathologic features and outcome of acute erythroid leukemia based on 2008 revised World Health Organization classification. Leuk Lymphoma, 2012;53;289-294.
    Pubmed
  4. Vardiman, JW, Thiele, J, Arber, DA, et al. The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes. Blood, 2009;114;937-951.
    Pubmed
  5. Guo, C, Inghirami, G, Ibrahim, S, Sen, F. Epistaxis and severe weakness in a patient with multiple myeloma. Therapy-related acute myeloid leukemia, pure erythroid leukemia. Arch Pathol Lab Med, 2006;130;1075-1076.
    Pubmed
  6. Funakoshi, Y, Matsuoka, H, Yamamoto, K, et al. Therapy-related pure erythroid leukemia with hepatic infiltration and hemophagocytic syndrome. Intern Med, 2011;50;3031-3035.
    Pubmed
  7. Xu, M, Finn, LS, Tsuchiya, KD, Thomson, B, Pollard, J, Rutledge, J. Pure erythroid leukemia following precursor B-cell lymphoblastic leukemia. Pediatr Dev Pathol, 2012;15;76-78.
    Pubmed
  8. Sadrzadeh, H, Hasserjian, R, Fathi, AT. Pure erythroid leukemia evolving from a therapy-related myelodysplastic syndrome secondary to treatment for chronic lymphocytic leukemia. Am J Hematol, 2013;88;240-241.
    Pubmed
  9. Pagano, L, Pulsoni, A, Mele, L, et al. Acute myeloid leukemia in patients previously diagnosed with breast cancer: experience of the GIMEMA group. Ann Oncol, 2001;12;203-207.
    Pubmed
  10. Ayala, RM, Martinez-Lopez, J, Albizua, E, Diez, A, Gilsanz, F. Clinical significance of Gata-1, Gata-2, EKLF, and c-MPL expression in acute myeloid leukemia. Am J Hematol, 2009;84;79-86.
    Pubmed

Article

Letter to the Editor

Blood Res 2014; 49(1): 69-72

Published online March 31, 2014 https://doi.org/10.5045/br.2014.49.1.69

Copyright © The Korean Society of Hematology.

Pure erythroid leukemia in advanced breast cancer

Pasquale Niscola1*, Andrea Tendas1, Mauro Minelli2, Alessio Perrotti1, Paolo de Fabritiis1, and Giovanni Del Poeta1

1Hematology Division, S. Eugenio Hospital, Rome, Italy.

2Oncology Unit, S. Eugenio Hospital, Rome, Italy.

Correspondence to: Pasquale Niscola. Hematology Division, S. Eugenio Hospital, Piazzale dell'Umanesimo 10, 00144, Rome, Italy. pniscola@gmail.com

Received: November 20, 2013; Revised: January 6, 2014; Accepted: March 4, 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Fig 1.

    Figure 1.

    Bone marrow smears (×400, panoptical staining) showing several erythroblasts in different maturation phases with clear dyserythropoietic features (maturative asynchronism, cytoplasmic blebs). (A) A bone marrow smear revealed megaloblastoid proerythroblasts with polychromatophilic cytoplasm, multiple cytoplasmic blebs, and polylobated hyperdiploid nucleus with finely dense chromatin. (B) A bone marrow smear revealed giant proerythroblast with scarce basophilic cytoplasm and round nucleus with immature chromatin.

    Blood Research 2014; 49: 69-72https://doi.org/10.5045/br.2014.49.1.69

    Fig 2.

    Figure 2.

    Bone marrow trephine biopsy at diagnosis of pure erythroid leukemia. (A) Medium magnification (×200) shows a predominant bone marrow population composed of atypical immature erythroid precursors (more than 90% with nucleated cells). (B) High magnification (×400) revealed numerous atypical erythroid precursors and dyserythropoiesis. (C) Glycophorin-A immunostain expressed by the atypical erythroid neoplastic precursors. (D) Linker for activated T-cells immunostain shows dysmegakaryocytopoiesis with a micromegakaryocytes and a population of immature megakaryoblasts.

    Blood Research 2014; 49: 69-72https://doi.org/10.5045/br.2014.49.1.69

    References

    1. Wang, SA, Hasserjian, RP. Erythroid proliferations in myeloid neoplasms. Hum Pathol, 2012;43;153-164.
      Pubmed
    2. Liu, W, Hasserjian, RP, Hu, Y, et al. Pure erythroid leukemia: a reassessment of the entity using the 2008 World Health Organization classification. Mod Pathol, 2011;24;375-383.
      Pubmed
    3. Liu, CJ, Hong, YC, Yang, CF, et al. Clinicopathologic features and outcome of acute erythroid leukemia based on 2008 revised World Health Organization classification. Leuk Lymphoma, 2012;53;289-294.
      Pubmed
    4. Vardiman, JW, Thiele, J, Arber, DA, et al. The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes. Blood, 2009;114;937-951.
      Pubmed
    5. Guo, C, Inghirami, G, Ibrahim, S, Sen, F. Epistaxis and severe weakness in a patient with multiple myeloma. Therapy-related acute myeloid leukemia, pure erythroid leukemia. Arch Pathol Lab Med, 2006;130;1075-1076.
      Pubmed
    6. Funakoshi, Y, Matsuoka, H, Yamamoto, K, et al. Therapy-related pure erythroid leukemia with hepatic infiltration and hemophagocytic syndrome. Intern Med, 2011;50;3031-3035.
      Pubmed
    7. Xu, M, Finn, LS, Tsuchiya, KD, Thomson, B, Pollard, J, Rutledge, J. Pure erythroid leukemia following precursor B-cell lymphoblastic leukemia. Pediatr Dev Pathol, 2012;15;76-78.
      Pubmed
    8. Sadrzadeh, H, Hasserjian, R, Fathi, AT. Pure erythroid leukemia evolving from a therapy-related myelodysplastic syndrome secondary to treatment for chronic lymphocytic leukemia. Am J Hematol, 2013;88;240-241.
      Pubmed
    9. Pagano, L, Pulsoni, A, Mele, L, et al. Acute myeloid leukemia in patients previously diagnosed with breast cancer: experience of the GIMEMA group. Ann Oncol, 2001;12;203-207.
      Pubmed
    10. Ayala, RM, Martinez-Lopez, J, Albizua, E, Diez, A, Gilsanz, F. Clinical significance of Gata-1, Gata-2, EKLF, and c-MPL expression in acute myeloid leukemia. Am J Hematol, 2009;84;79-86.
      Pubmed
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