alexa The Diagnostic Challenge of Therapy-Related Pure Erythroid Leukemia Arising in the Setting of Multiple Myeloma
ISSN: 2329-6917

Journal of Leukemia
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Case Report

The Diagnostic Challenge of Therapy-Related Pure Erythroid Leukemia Arising in the Setting of Multiple Myeloma

Harold Lance Evans1, Zeba Singh1*, Ashraf Badros2, Ying Zou1, Daisy Alapat3 and Qing C Chen1

1Department of Pathology, University of Maryland School of Medicine, Baltimore, USA

2Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine, Baltimore, USA

3Department of Pathology, University of Arkansas for Medical Sciences, USA

*Corresponding Author:
Zeba Singh, MD
Department of Pathology
University of Maryland School of Medicine
22 S. Greene St., Baltimore, MD 21201,USA
Tel: 410-328-2146
E-mail: [email protected]

Received date: May 07, 2014; Accepted date: June 25, 2014; Published date: July 4, 2014

Citation: Evans HL, Singh Z, Badros A, Zou Y, Alapat D, et al. (2014) The Diagnostic Challenge of Therapy-Related Pure Erythroid Leukemia Arising in the Setting of Multiple Myeloma. J Leuk (Los Angel) 2:141. doi: 10.4172/2329-6917.1000141

Copyright: © 2014 Evans et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



We report two interesting cases of patients with multiple myeloma, who developed a therapy-related myeloid neoplasm in the form of pure erythroid leukemia. In both cases, it was difficult to differentiate the erythroid blasts from plasma blasts by morphology alone. The diagnostic picture was further confounded by the presence of a hyperdiploid karyotype (case 1), which is a frequent cytogenetic abnormality in multiple myeloma but distinctly uncommon in acute myeloid leukemia. These cases highlight the diagnostic challenge encountered with pure erythroid leukemia in the setting of multiple myeloma, and underscore the importance of immunohistochemistry, cytogenetics, and gene rearrangement studies in resolving the diagnostic conundrum. To the best of our knowledge pure erythroid leukemia with a hyperdiploid karyotype arising in a background of pre-existing multiple myeloma, has not previously been reported.


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