Symptoms, diagnosis, treatment and outlook

Erythroleukemia is a cancer of the blood and bone marrow. It is a rare subtype of acute myeloid leukemia (AML) and is sometimes called acute erythroid leukemia or M6-AML.

Erythroleukemia occurs in 3-5% of all people with AML. Erythroleukemia is different from other AML subtypes because it primarily involves a type of blood-forming cells called erythroblasts.

Knowing your AML subtype can be very important in determining the best treatment options available. If you have been diagnosed with erythroleukemia by a doctor, or if you are unsure which AML subtype you have, talk to your doctor about how your AML subtype might affect your treatment and outlook.

Erythroleukemia occurs when your body produces a large amount of abnormal red blood cells in your blood and bone marrow.

Bone marrow is a soft tissue found in the center of your bones. It is responsible for the production of new blood cells and other important cells in your body.

There are two types of bone marrow:

  • Red bone marrow makes red blood cells, white blood cells, or platelets.
  • Yellow bone marrow produces cartilage, fat, or bone cells.

AML occurs when there is a problem with the red bone marrow cells called myeloid cells.

In AML, damage occurs to the DNA of developing blood cells. Scientists do not know the exact cause of this DNA damage. DNA damage causes your blood cells to start growing and dividing uncontrollably.

These rapidly dividing cells don’t function properly and don’t die at a natural time in their life cycle, unlike healthy blood cells. Instead, they accumulate and spread throughout the body. Over time, cancer cells outnumber healthy cells in the blood.

As a subtype of AML, erythroleukemia always occurs in red bone marrow. But it mainly affects specific red cells in the bone marrow called erythroblasts. Erythroblasts are cells that make erythroid cells, a type of red blood cells.

Erythroleukemia can occur at any age and in both men and women, but usually affects men with an average age of 65. It is sometimes also present in very young children.

Doctors consider it very rare. The only large study to track the total number of cases in a population group was in England in the 1980s and 1990s. It found that this type of cancer occurs in less than 1 in a million people per year.

Erythroleukemia can also occur with other cancers, including myeloproliferative neoplasms or myelodysplastic syndromes (MDS).

Other risk factors include:

  • history of exposure to ionizing radiation
  • history of chemotherapy for another cancer
  • rare genetic chromosomal abnormalities

Over time, abnormal blood cells may outnumber healthy blood cells. Not having enough healthy blood cells in your body can cause the following symptoms:

Your doctor will ask you about your symptoms, review your medical and family history, and perform a physical exam.

Doctors cannot diagnose erythroleukemia from a single test. To diagnose erythroleukemia and differentiate it from other AML subtypes or other blood cancers, doctors will take a sample of blood or bone marrow to send to a lab for testing.

Blood and bone marrow tests for erythroleukemia may include the following:

  • Complete blood count (FCS): A CBC uses a sample of your blood to count the number of red blood cells, white blood cells, and platelets. People with LAM often have a high white blood cell count and a low red blood cell and platelet count.
  • Peripheral blood smear: A blood smear examines the shape, size and amount of cells in the blood. This test specifically looks for leukemia (blast) cells, which are not normally present in the blood.
  • Cytochemistry: This test exposes blood cells to chemical dyes (dyes) that react with specific types of leukemia cells. This test, in particular, can help your doctor differentiate AML from acute lymphocytic leukemia.
  • Bone marrow puncture and biopsy: A doctor may take a sample of bone marrow or a small section of bone containing marrow and examine it under a microscope.
  • Flow cytometry: This test identifies specific markers on cells by seeing if certain antibodies stick to them. Flow cytometry can help classify AML into different subtypes. This is called immunophenotyping.
  • Molecular tests: These tests look for specific changes in the chromosomes (long strands of DNA) and genes in leukemic cells.

Doctors will then use this information to understand which AML subtype you have based on a Classification system developed by the World Health Organization (WHO).

Doctors previously divided erythroleukemia into two categories (erythroid/myeloid type erythroleukemia and pure erythroid leukemia), but this is no longer the case. Scientists have proposed that erythroleukemia belongs to a category of blood cancers called MDS. However, there are still some debate about how doctors should classify these cancers.

Treatments for erythroleukemia are similar to treatments for other AML subtypes.

Current treatment includes intensive chemotherapy and stem cell transplants.

Chemotherapy drugs work by killing cancer cells and stopping them from growing. Chemotherapy can also affect healthy cells and cause many side effects.

Common side effects of chemotherapy include:

Stem cells are special human cells that can develop into many different cell types, including red blood cells. Stem cell transplants, also called bone marrow transplants, restore bone marrow cells lost due to chemotherapy.

Not everyone with erythroleukemia is eligible for a stem cell transplant. A stem cell transplant is a very intensive process and carries many risks, including:

  • infection
  • bleeding
  • lung problems
  • graft-versus-host disease, which is a condition in which donor cells attack your body
  • hepatic veno-occlusive disease
  • graft failure, which means the transplanted cells do not produce new cells as expected

Doctors often measure the outlook in terms of 5-year overall survival. 5-year overall survival describes the percentage of people with a certain disease who are still alive 5 years after their diagnosis.

The 5-year survival rate for AML is 30.5%according to the National Cancer Institute.

Keep in mind that the 5-year survival rate is calculated based on past data. It does not take into account recent advances in treatments or new research that leads to a better understanding of a disease.

In general, the outlook is worse for people with erythroleukemia than for other types of AML, because erythroleukemia can be more difficult to treat than other types of AML. As it is so rare, there is no 5-year survival rate available. According to a few older studies, the median survival for erythroleukemia is between 3 and 9 months.

Many other factors can affect your outlook aside from subtype. According to American Cancer Societythese factors also play a role in your outlook and response to treatment:

  • chromosomal abnormalities
  • genetic mutations
  • markers on leukemic cells
  • white blood cell count
  • have another blood disorder
  • infections
  • where in the body the cancer has spread
  • your age and general health

Erythroleukemia is a rare blood cancer and a subtype of AML. Although the outlook is considered worse than that of other types of AML, much progress has been made in recent years to help understand the characteristics and genetic changes that cause this type of blood cancer. This information could be useful to scientists trying to develop new therapies.

If you have erythroleukemia, your doctor may recommend that you enroll in a clinical trial to study new treatment options. Be sure to speak with a doctor about the potential benefits and risks of participating in a clinical trial.

Source link

About Chris Y. Camp

Check Also

US sues Idaho over abortion law, cites medical treatment

BOISE, Idaho (AP) — The Justice Department on Tuesday filed a lawsuit challenging Idaho’s restrictive …