A Case of Pure Red Cell Aplasia Associated with B-cell Chronic Lymphocytic Leukemia / 대한혈액학회지

ABSTRACT

Pure red cell aplasia (PRCA) is a rare disorder, which is characterized by severe anemia associated with reticulocytopenia and absence of erythroid precursor cells in the bone marrow. Recently we experienced a patient with B-cell chronic lymphocytic leukemia associated with PRCA, which was successfully treated with prednisone. A 50-year-old man was admitted because of lymphocytosis. The leukocyte count was 26,800/nL with 82% abnormal mature lymphocytes. Neither anemia nor thrombocytopenia was present. Many abnormal lymphocytes and erythroblasts were seen in the bone marrow. The surface markers of these cells were positive for CD5, CD19, CD20, CD22, and surface immunoglobulin. The patient was diagnosed of B-CLL in Binet-Rai stage A (II), and was treated with chlorambucil. Six months later, severe anemia (hemoglobin 5.9g/dL) with reticulocytopenia developed. In the bone marrow at that time, neutrophils and megakaryocytes besides leukemic cells were preserved, but marked decrease of erythroblasts, a pattern of PRCA was observed. After one-month's observation, we prescribed prednisone. After four weeks of such therapy the patient's hemoglobin reached 10.9g/dL, and he needed no further transfusion.