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Acute Erythroblastic leukemia (M6)


Erythroleukemia is a rare form of acute myeloid leukemia (AML) where the myeloproliferation is of erythrocyte precursors. M6 or erythroleukemia is rare and difficult to diagnose. More than 30-50% of the nucleated marrow cells are abnormal nucleated red blood cells. Erythroleukaemia  myeloid blasts express a variety of myeloid markers, similar to othe subtypes of AML ­ CD13, CD33, CD117 (ckit) and MPO. The erythroblasts lack myeloid antigens but are positive to glycophorin A.

In Pure erythroid leukaemia: Erythroid blasts which have differentiated will be positive with glycophorin A but negative with MPO and myeloid markers. The more immature blasts are difficult to identify as erythroid because they are usually negative for glycophorin A. Immature erythroid progenitors may be detected using carbonic anhydrase 1 or CD36. Although CD36 is not specific for erythroid progenitors, negative markers for megakaryocytes and monocytes will aid the diagnosis. Chromosome Abnormalities are  8+, -5, del(5q), and -7.   

The prognosis of acute erythroid leukaemia is reported as poor. It is, however, important to differentiate de novo from secondary or therapy related erythroid leukaemia, where the later have a worse prognosis.



























Above case shows (lymp-green, grans-blue, ERYTHROBLAST-red, Monocytes-pink) positivity for CD71, CD235a, CD36, CD11b and negativity for MPO, CD34, CD19, CD117, CD13,  cCD79a, cCD3


  • Bennett JM, Catovsky D, Daniel MT, Flandrin G, Galton DAG, Gralnick HR, Sultan C. Proposed revised criteria for the classification of acute myeloid leukemia: A report of the French-American-British Cooperative group. Annals of Internal Medicine 1985; 103: 620–625 [PubMed]

  • Villeval J, Cramer P, Lemoine F, Henri A, Bettaieb A, Ber-Naudin F, Beuzard Y, Berger R, Flandrin G, Breton-Gorius J, Vainchenker W. Phenotype of early erythroblastic leukemias. Blood 1986; 68: 1167–1174[PubMed]

  • Greaves M, Sieff C, Edwards P. Monoclonal antiglycophorin as a probe for erythroleukemias. Blood 1983; 80: 1105–1115 [Google Scholar]

  • Garand R, Duchayne E, Blancherd D, Robillard N, Kuhlein E, Fenneteau O, Salmon-Nguyen F, Grange M, Rousselot P, Demur C, Talmant P, Radford I, Flandrin G. and the Groupe Francais d'Hematologie Cellulaire. Minimally differentiated erythroleukaemia (AML M6 “variant”): A rare subset of AML distinct from AML M6. British Journal of Haematol-Ogy 1995; 90: 868–875[PubMed]

  • Fourth International Workshop on Chromosomes in Leukemia: Correlation between morphology and karytoype. Cancer Genetic Cytogenetic 1982; 11: 275 [Google Scholar]

  • Cardamone J, Kimmerle R, Marshall E. Development of acute erythroleukemia in B-cell immunoproloiferative disorders after prolonged therapy with alkylating drugs. The American Journal of Medicine 1974; 57: 836–842[PubMed]

  • Chabner B. Second neoplasm-a complication of cancer chemotherapy. New England Journal of Medicine 1977; 297: 213–215[PubMed]

  • Dameshek W, Gum F. Leukemia. Grune and Stratton, Inc, New York 1964 [Google Scholar]

  • Karle H, Killmann S-A, Jensen M, Nielson J. The vagaries of erythroleukaemia. Acta Medica Scandinavica 1974; 196: 245–253[PubMed]

  • Roman C, Woessns S, Saez-Serrania J. Acute erythromy-elosis after benzene poisoning Acta Haematologic 1968; 40: 234–237[PubMed]

  • Fomi A, Moreo L. Chromosome studies in a case of benzene-induced erythroleukaemia. European Journal of Cancer 1969; 5: 459–463[PubMed]

  • Jandl J. Blood: Textbook of Hematology. Little. 1987; 647, Brown and Company [Google Scholar]

  • Atkinson J, Hrisinko M, Weil S. Erythroleukemia: A review of 15 cases meeting the 1985 FAB criteria and survey of the literature. Blood Reviews 1993; 6: 204–214

    [Google Scholar]

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