目的:提高对纯红系白血病(PEL)的认识。方法:报道了1例骨髓增生异常综合-难治性血细胞减少伴原始细胞增多2型(MDS-RAEB2)转化的PEL并进行相关文献复习。结果:按WHO诊断分型标准为M6b。患者贫血症状显著,全血细胞减少。骨髓红系细胞比例≥80%伴形态异常,原红细胞呈现显著巨幼样变,胞质强嗜碱性、无粒、空泡易见且常成串出现,PAS强阳性,POX阴性。白血病细胞表达CD36和血型糖蛋白A阳性,部分表达CD117、CD71阳性,缺乏髓系相关抗原表达。出现染色体异常。治疗采用蒽环类药物加阿糖胞苷的化疗方案,未缓解,放弃治疗。结论:PEL罕见,传统化疗疗效差,预后差。
Objective:To better understand the characteristic of pure erythroid 1eukemia(PEL).Method: A rare case of pure erythroid leukemia evolved from myelodysplastic syndrome-refractory anemia with excess blasts Type-2(MDS-RAEB2)was reported the related literatures were reviewed.Result:According to the WHO diagnostic criteria,PEL is classified as M6b.Patients'anemia symptoms are notable,most with pancytopenia.Bone marrow erythroid cell ratio is more than or equal to 80% with abnormal morphology and the original red cells show significant megaloblastic amyloidosis,strong basophilic cytoplasm,no grain,visible vacuoles often occurring in clusters,PAS positive,POX negative.Leukocytes'expression of CD36 and glycophorin A are often positive,partly CD117 positive and low expression of CD71,lacking of myeloid-associated antigen expression.Chromosomal abnormalities can be found in more than 70% patients without specific genetic alterations.-5/5q-,-7/7q-or +8 changes and complex karyotype abnormalities are most common.Anthracycline plus cytarabine chemotherapy regimens are more adopted.Chemotherapy complete remission(CR)rate of primary PEL is about 50%-60% and only 10%-20% in secondary PEL with short remission period and median survival time is 4-5 months.Conelusion:Pure erythroleukemia is very rare,Curative effect and prognosis are poor with the traditional chemotherapy.