Erythroleukemia is a cancer of the blood and bone marrow, and a rare type of acute myeloid leukemia.

Erythroleukemia, or acute erythroid leukemia, is a blood and bone marrow cancer. Erythroleukemia is a rare type of acute myeloid leukemia (AML). Only 3-5% of AML cases are erythroleukemia.

The reported annual rates of erythroleukemia are around 0.077 per 100,000 people. In 64-70% of these reported cases, erythroleukemia affects males with an average age of 65 years.

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Erythroleukemia is a rare subtype of acute myeloid leukemia (AML).

AML is a type of leukemia that begins in bone marrow due to abnormal blood-forming cells, called myeloid cells.

AML can easily spread from the bone marrow into the blood and may also spread to other areas of the body such as the lymph nodes, spleen, liver, or nervous system.

Doctors may categorize erythroleukemia further into the following two subtypes, depending on which cell changes are present:

  • Pure erythroid leukemia (PEL): Specific marrow cells consist of at least 80% of a particular type of erythroblasts.
  • Erythroid/myeloid leukemia (EML): Erythroid cells consist of 50% or more of certain marrow cells, and myeloblasts consist of 20% or more of non-erythroid cells.

Erythroblasts are cells occurring in red bone marrow. Myeloblasts are blood-forming cells that occur in bone marrow. Erythroid cells are a type of red blood cell.

Learn more about acute myeloid leukemia here.

Reduced blood production in erythroleukemia can lead to a lower white blood cell count and decreased platelets and red blood cells. These changes may cause symptoms such as:

To diagnose AML and any subtypes such as erythroleukemia, doctors may use a range of blood and bone marrow tests. Doctors will take a blood or bone marrow sample to send off for testing in a laboratory.

A hematopathologist, an expert in diagnosing diseases of blood cells, will then examine the samples under a microscope.

Tests for erythroleukemia may include the following:

  • Complete blood count (CBC): CBC is a blood sample to check the amounts of red and white blood cells and platelets in the blood.
  • Peripheral blood smear: This is a blood sample to check the shape, size, and amount of red blood cells, white blood cells, and platelets in the blood to check for leukemia blast cells.
  • Bone marrow samples: A doctor may take a liquid bone marrow sample or a small section of bone containing marrow, usually from the hip bone. Doctors will then examine the samples for unusual cell changes.
  • Flow cytometry: Flow cytometry, or immunophenotyping, is a test that identifies specific markers on cells which helps to compare cancer cells to normal cells in a blood or bone marrow sample.
  • Molecular tests: Doctors may use a range of tests to check the chromosomes and genes in any leukemia cells.

Doctors may also carry out other tests to check a person’s overall health, such as taking a blood chemistry profile and checking their heart health.

Diagnostic tests for erythroleukemia may take place in a doctor’s office or hospital.

There are two main classification systems to determine which subtype of AML people have.

The French-American British (FAB) classification was the original system, and the World Health Organization (WHO) system is a newer classification.

The WHO system categorizes AML into groups depending on specific gene or chromosomal abnormalities.

Learn more about diagnostic tests for leukemia here.

Treatment for erythroleukemia includes chemotherapy and stem cell transplants.

Chemotherapy is the first-line option for treating erythroleukemia.

Chemotherapy drugs target cancer cells to destroy them and prevent them from multiplying. People may have chemotherapy drugs orally or intravenously through a vein.

Chemotherapy can cause side effects, such as:

  • nausea and vomiting
  • appetite loss
  • hair loss
  • fatigue
  • increased risk of infection

Stem cell transplants replace cancerous cells with stem cells. Stem cell transplants may be suitable for some people with erythroleukemia, depending on the stage of the disease and how it has spread in the body.

Learn more about treatments and medications for AML here.

According to a 2018 article, erythroleukemia can be difficult to treat, and people’s response to standard therapies is generally poor. On average, people live between 3–9 months after initial diagnosis.

The article recommends that people with erythroleukemia consider taking part in clinical trials that are investigating treatments with:

  • LSD-1 inhibitors
  • bromodomain inhibitors
  • BCL2 inhibitors
  • antibody-drug conjugates

Possible complications of treatment include relapse and toxicity to chemotherapy drugs.

The outlook for erythroleukemia can depend on several factors, such as whether specific chromosomal abnormalities are present or not.

Erythroleukemia is a blood and bone marrow cancer and a rare type of AML. Erythroleukemia most commonly affects older males.

Erythroleukemia may cause fatigue, fever, bruising, and joint or bone pain. To diagnose erythroleukemia, doctors may take blood and bone marrow samples to send to a laboratory for examination.

Doctors may use the WHO classification system to identify the subtype of AML in order to diagnose erythroleukemia.

Treatment for erythroleukemia may include chemotherapy and stem cell transplants. People may also be eligible to take part in clinical trials and they can discuss this with a doctor.