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Oncohematology

Acute Erythroid Leukemia: Morphology and Immunophenotype

A clinical case of acute erythroid leukemia: pancytopenia, blast cells in the smear, erythroid dysplasia, and flow cytometry (CD71+, CD235a+).

Anna Belen Anna Belen 1 min
Peripheral blood smear: blast-like cell with basophilic cytoplasm
Peripheral blood smear: blast-like cell with basophilic cytoplasm
Peripheral blood smear: atypical blast with cytoplasmic projections
Peripheral blood smear: atypical blast with cytoplasmic projections
Biochemical blood test form: elevated LDH, urea, and creatinine levels
Biochemical blood test form: elevated LDH, urea, and creatinine levels
Bone marrow smear: erythroblast proliferation and a binucleated precursor
Bone marrow smear: erythroblast proliferation and a binucleated precursor
Bone marrow smear: clusters of immature erythroid elements with basophilia
Bone marrow smear: clusters of immature erythroid elements with basophilia
Bone marrow smear: severe dysplasia with a multinucleated erythroblast
Bone marrow smear: severe dysplasia with a multinucleated erythroblast
Bone marrow smear: hypercellularity due to erythroid lineage proliferation
Bone marrow smear: hypercellularity due to erythroid lineage proliferation
Bone marrow smear: dysplastic changes and cytoplasmic vacuolization
Bone marrow smear: dysplastic changes and cytoplasmic vacuolization
Bone marrow smear: megaloblastoid transformation and dyserythropoiesis
Bone marrow smear: megaloblastoid transformation and dyserythropoiesis
Flow cytometry printout: CD45- blasts, positive for CD71 and CD235a
Flow cytometry printout: CD45- blasts, positive for CD71 and CD235a

👉Clinical case - acute erythroid leukemia. ✅A 92-year-old male was admitted to the emergency department with retrosternal pain and dyspnea, suspected acute heart failure - troponin 198 ng/L (N=0-14). Hepatosplenomegaly was also detected. ✅Pancytopenia in peripheral blood: Leukocytes (WBC) 3.01×109/L, Hemoglobin (Hb) 59 g/L (normochromic normocytic), Platelets (PLT) 9×109/L. ✅Single blast-like cells in the peripheral blood smear (see photo). ✅Bone marrow aspirate shows marked proliferation of immature erythroid elements with some dysplasia (multinuclearity, cytoplasmic vacuolization). ✅Immunophenotyping revealed a CD45 negative population, positive for erythroid markers CD71, CD235a, CD36, and negative for CD34, CD117, MPO, CD38, CD41, CD61, CD64, CD33, HLA-DR. ✅Histology conclusion: acute erythroid leukemia.

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