Acute Erythroid Leukemia: A Review [Abstract]

[N A J Med Sci. 2012;5(2):110-118.] PDF File

Daniela Mihova, MD, FCAP;* Lanjing Zhang, MD, MS, FCAP

Acute erythroid leukemia is a rare form of acute  myeloid leukemia. It accounts for  World Health Organization 2008 classification, it falls under the category of acute myeloid  leukemia, not otherwise specified and is further divided into two subtypes: erythroid leukemia  (erythroid/myeloid) and pure erythroid leukemia. Currently, erythroleukemia (erythroid/myeloid)  is defined as 50% or more erythroid precursors and > 20% blasts of the non-erythroid cells.  By definition, pure erythroid leukemia is composed of > 80% erythroid precursors.  Acute erythroid leukemia is a diagnosis of exclusion and difficulty. This review discusses  its differential diagnoses, which present with erythroid proliferation, such as myelodysplastic  syndrome with erythroid proliferation, acute myeloid leukemia with myelodysplasia related  changes, therapy related acute myeloid leukemia, myeloproliferative neoplasms with erythroblast  transformation, acute myeloid leukemia with recurrent genetic abnormalities and other types  of hematologic neoplasms. Additionally, reactive conditions such as erythropoietin treatment,  vitamin B12 and folate deficiency, toxin exposure and congenital dyserythropoiesis should  be excluded. As a result, the frequency of acute erythroid leukemia diagnosis has been reduced.  Important adverse prognostic factors will be summarized, including presence of complex cytogenetic  karyotype as the most important one. Additional larger studies are needed to better understand  acute erythroid leukemia, with a focus on diagnostic tools, its heterogeneity and cytogenetic  and molecular characteristics for potential therapeutic targets. 

Key Words: leukemia,  WHO classification, acute erythroid leukemia, differential diagnosis, prognosis leukemia,  WHO classification, acute erythroid leukemia, differential diagnosis, prognosis 


Daniela Mihova, MD, FCAP;1* Lanjing Zhang, MD, MS, FCAP2,3

1 Pathology Department and Clinical Laboratories, Flushing Hospital Medical Center,  Flushing, NY
2 Department of Pathology, University Medical Center at Princeton, Princeton, NJ
3 Department of Pathology and Laboratory Medicine, Robert Wood Johnson Medical School-UMDNJ,  New Brunswick, NJ 

*Corresponding Author: Department  of Pathology and Clinical Laboratories, Flushing Hospital Medical Center, Flushing,  NY 11355. Tel: 718-670-5723. (Email: 



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