Abstract • A 3-year-old girl had pancytopenia and bone marrow erythroid hypoplasia. The pancytopenia resolved without therapy, but the erythroid hypoplasia persisted for four months in spite of a five-week course of corticosteroid therapy. She responded briefly when androgens were added to the corticosteroid regimen, but within three weeks of stopping therapy she developed acute lymphocytic leukemia. The differential diagnosis of RBC aplasia in childhood is discussed. To our knowledge, this is the first case reported with erythroid hypoplasia as a prodrome of acute lymphocytic leukemia of childhood. (Am J Dis Child 132:763-764, 1978) References 1. Melhorn DK, Gross S, Newman AJ: Acute childhood leukemia presenting as aplastic anemia: The response to corticosteroids . J Pediatr 77:647-652, 1970.Crossref 2. Toledano SR: Pre-leukemic phase in childhood acute lymphoblastic leukemia . J Pediatr 91:507-508, 1977.Crossref 3. Wang WC, Mentzer WC: Differentiation of transient erythroblastopenia of childhood from congenital hypoplastic anemia . J Pediatr 88:784-789, 1976.Crossref 4. Krantz SB: Annotations: Pure red cell aplasia . Br J Haematol 25:1-6, 1973.Crossref 5. Sallan SE, Buchanan GR: Selective erythroid aplasia during therapy for acute lymphoblastic leukemia . Pediatrics 59:895-898, 1977. 6. Schmid JR, Kiely JM, Pease G, et al: Acquired pure red cell agenesis . Acta Haematol 30:255-270, 1963.Crossref 7. Savage RA: Pure red cell aplasia: A preleukemic state . Cleve Clin Q 43:257-274, 1976.Crossref 8. Soutter L, Emerson CP: Elective thymectomy in the treatment of aregenerative anemia associated with monocytic leukemia . Am J Med 28:609-614, 1960.Crossref 9. Abeloff MD, Waterbury L: Pure red blood cell aplasia and chronic lymphocytic leukemia . Arch Intern Med 134:721-724, 1974.Crossref 10. D'Oelsnitz M, Vincent L, DeSwarte M, et al: Proceedings: Acute lymphoblastic leukemia following treatment of Blackfan-Diamond's disease . Arch Fr Pediatr 32:582, 1975. 11. Linman JW, Saarni MI: The pre-leukemic syndrome . Semin Hematol 11:93-100, 1974.
American Journal of Diseases of Children – American Medical Association
Published: Aug 1, 1978