Leukoerythroblastosis Symptoms, Causes, Diagnosis, Treatment

Leukoerythroblastosis is a syndrome that is poorly defined and uncommon. It is distinguished by leukocytosis, a left shift, and an increased number of nucleated RBCs in comparison to the extent of anemia. This syndrome is associated with neoplasia or leukemia in the bone marrow, a severe infection, myelofibrosis, hemolysis, or other unrelated conditions. Leukoerythroblastosis is a rare disease that causes the blood to have a lot of white blood cells, erythroid and myeloid blast cells. Early childhood leukoerythroblastosis is most frequently caused by osteopetrosis, viral infections, and juvenile myelomonocytic leukemia.

Leukoerythroblastosis Symptoms

Establishing the underlying condition, such as advanced cancer, lymphoma, or granulomatous disease, should be the primary focus of the history and clinical examination. For information regarding congenital and inherited types of the disease, family history is crucial.

The underlying medical disease, such as metastatic cancer, lymphoma, or tuberculosis, is typically reflected in the physical features of this disease. Skin pallor may also result from anemia. Petechiae or ecchymoses could result from severe thrombocytopenia. Severe neutropenic patients may develop an infection and show signs of fever.

Leukoerythroblastosis Causes

Leukoerythroblastosis has several causes. The following are some of the causes of this condition:

1. Bone marrow infiltration: When a hematological bone marrow issue is suspected or when there is no sign of a primary tumor (particularly a carcinoma), trephine biopsy and bone marrow aspiration are recommended.
2. Metastatic Carcinoma: If the existence of metastatic disease is not evident from previous tests or if documentation is required, a bone marrow examination is appropriate.
3. Some other associated causes of leukoerythroblastosis are:

• Primary myelofibrosis.
• Serious infection.
• Severe injury or shock.
• Severe hemolysis.

Leukoerythroblastosis Diagnosis

The patient's medical background, physical exam, peripheral blood smear, bone marrow biopsy, and complete blood count, are all used to establish the diagnosis. The initial diagnostic procedure for leukoerythroblastosis involves examining a blood sample under a microscope. The appearance of red blood cells with nuclei that are teardrop-shaped or juvenile granulocyte precursor cells, suggests leukoerythroblastosis because the relocated hematopoietic cells start to conduct extramedullary hematopoiesis, which are signs of leukoerythroblastosis. These immature granulocytes can be seen on smears of blood taken from the body's edges. When fibrosis, cancer, or another infiltrative condition significantly replaces the healthy bone marrow compartment, the diagnosis is verified by a bone marrow biopsy.

Leukoerythroblastosis Treatment

Transfusions of packed red blood cells are used to treat anemia. When erythropoietin levels are low, patients may benefit from additional erythropoietin medication. Patients with various cytopenias typically do not require therapy unless they are bleeding or have an infection. In cases where the cause is unknown, supportive care is given. No significant results have been seen with erythropoietin and corticosteroids. In many individuals, hydroxyurea reduces the size of the spleen and normalizes RBC values, although the response does not occur until six to twelve months of treatment have passed. The effects of thalidomide may be mild, but they come with potentially dangerous levels of exhaustion, and an elevated risk of thrombosis.