Abstract
Children with acute leukemia often have erythrocytes with ‘fetal-like’ features. To examine the relationship of the type and phase of the leukemia, we studied 39 children with newly diagnosed acute lymphocytic (ALL) and 5 with acute nonlymphocytic leukemia (ANLL). 25 patients were evaluated during chemotherapy, 3 off therapy, and 12 at relapse. Macrocytosis and/or anisocytosis (increased coefficient of variation of red cell size, or %CV, ie SD/mean) were seen in 70% of new ALL, 80% of new ANLL, and 90% of ALL and 100% of ANLL on treatment. F-cells (acid elution) were increased in 24% of ALL and 80% of ANLL at diagnosis, and 61% of ALL and 75% of ANLL during chemotherapy. Hb F levels (alkali denaturation) were elevated in 8, 40, 29 and 33% respectively. Nonleukemic controls for chemotherapy (6 patients with osteogenic sarcoma) all had macrocytosis and/or anisocytosis, and 83% had increased F-cell proportions, although Hb F was normal in all. Features at leukemic relapse on chemotherapy were similar to those during treated remissions. Abnormal red cells are common at diagnosis in ANLL, where they may belong to the malignant clone, and ALL, where stress erythropoiesis and/or leukemic factors may be contributory. During chemotherapy, drug-related erythrocyte changes and marrow suppression and recovery are added to factors due to leukemia itself. Thus leukemia, chemotherapy, and the combination lead to macrocytosis, anisocytosis, and ‘fetal-like’ erythrocytes.
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Alter, B., Weiner, M. & Harris, M. ERYTHROCYTE CHARACTERISTICS IN CHILDHOOD ACUTE LEUKEMIA. Pediatr Res 21 (Suppl 4), 296 (1987). https://doi.org/10.1203/00006450-198704010-00773
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DOI: https://doi.org/10.1203/00006450-198704010-00773