Pure Erythroid Leukemia Evolving From A Therapy-Related Myelodysplastic Syndrome Secondary To Treatment For Chronic Lymphocytic Leukemia

摘要

A 75-year-old male carried a diagnosis of chronic lym-phocytic leukemia (CLL) for many years for which he received several courses of chemotherapy, in succession cladribine, cyclophosphamide, vincristine, and prednisone, and fludarabine and cyclophosphamide. Approximately 14 years after his CLL diagnosis, he developed progressive and refractory thrombocytopenia which did not respond to anti-CLL therapy. A bone marrow biopsy was performed and was markedly hypercellular and left shifted. There were several lymphoid aggregates consistent with CLL, but comprising only about 20% of the marrow cellularity. The hypercellular areas of hematopoiesis contained increased small, dysplastic megakaryocytes, and increased blasts (Image 1A), confirmed by CD34 immunohistochemistry (Image 1B).