Two Cases of Acute Erythroid Leukemia Presenting with Marked Macrocytic Anemia, Reticulocytosis and Hemolysis

Abstract

Case 1. The laboratory findings of a hematological analysis of a 53-year-old woman with palpitations and dyspnea revealed the following: red blood cell (RBC) count: 9.4×10 5 /μL with 60.0‰ reticulocytes; Hb: 3.7 g/ dL; mean corpuscular volume (MCV): 124.5 fL; white blood cell (WBC) count: 2,800/μL with 10.0% myeloblasts. Case 2. Similarly, a 42-year-old man with dizziness had a RBC count of 1.63×10 6 /μL with 24.0% reticulocytes, an Hb level of 6.0 g/dL, an MCV of 120.2 fL and a WBC count of 3,100/μL with 4.0% myeloblasts. Bone marrow aspirates in both patients confirmed a diagnosis of acute erythroid leukemia (AEL), which can present as marked macrocytic anemia with an MCV in excess of 120 fL and hemolysis.

Differential Diagnoses of Macrocytic Anemia, Reticulocytosis and Low Serum Haptoglobin in Patients with Myelodysplastic Syndromes/Acute Leukemia: Comment on "Two Cases of Acute Erythroid Leukemia Presenting with Marked Macrocytic Anemia, Reticulocytosis and Hemolysis"

“…However, they did not describe the detailed red blood cell (RBC) morphology. The published blood smear does not reveal the RBC morphology, and there are many overlapping RBCs (1). I would like to comment that there are many things to consider in both cases.…”

“…To the Editor I read with particular interest the manuscript by Ota et al (1). The authors stated that both patients presented with marked macrocytic anemia, reticulocytosis and hemolysis.…”