Acute erythroleukemia is a type of acute leukemia with a predominance of abnormal red blood cell proliferation. It can be divided into red leukemia and pure red cell leukemia, and its diagnosis is strictly dependent on bone marrow aspiration, which:
- Red leukemia with ≥50% erythrocytes in the bone marrow and ≥20% primitive cells (ie, abnormal maturation-impaired naïve cells, including primitive granulocytes, primitive + naïve monocytes);
- Pure erythroleukemia is extremely rare, with malignant proliferation of naïve erythroid cells in the bone marrow with ≥80% and no increase in primitive cells.
In 2016, the WHO made a major change for the diagnosis of acute erythroleukemia. Of the two subtypes, only the diagnosis of pure red-lineage leukemia was retained, and the diagnosis of red leukemia was eliminated.
Patients usually have significant anemia, with nucleated erythrocytes (naïve red blood cells) visible in peripheral blood and rapid clinical progression.
The disease can be secondary to other hematologic disorders such as myelodysplastic syndromes (MDS), chronic myeloproliferative neoplasms (MPN), and others.
Dr. Xin Li, Department of Hematology, Shanghai Renji Hospital South Hospital, also contributed to this Q&A