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Cureus 2018 Nov 4;10(11):e3541. Epub 2018 Nov 4.

Hematology / Oncology, The Brooklyn Hospital Center, Brooklyn, USA.

Breast tumors have a predilection for metastasizing to the bone leading to cells being displaced by the cancer cells subsequently producing immature leukocytes and erythrocytes in the peripheral blood. We present a case of a 57-year-old female who was found to have myelophthisic anemia secondary to stage four lobular breast carcinoma metastasized to the bone marrow after being misdiagnosed as having thrombotic thrombocytopenia purpura. Diagnosis of myelophthisic anemia requires a thorough workup and treatment is based upon secondary management of the malignancy. Read More

Blood 2018 03;131(9):1036

Stanford University School of Medicine.

Eur J Intern Med 2018 02 8;48:e7-e8. Epub 2017 Jul 8.

Department of Internal Medicine, The University of Texas Health Sciences Centre at Houston, Houston, TX, USA; Department of Critical Care, Pulmonary and Sleep Medicine, The University of Texas Health Sciences Centre at Houston, Houston, TX, USA. Electronic address:

J Immunother Cancer 2017 18;5:34. Epub 2017 Apr 18.

Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065 USA.

Background: Myelophthisis due to melanoma is a rare phenomenon. Treatment strategies for patients with this serious complication of malignancy have not been well documented, and none have previously reported efficacy of immune checkpoint inhibition. Since bone metastases are not measurable lesions per standard response criteria, the efficacy of immune checkpoint inhibition in the bones is also not well described. Read More

Rev Fac Cien Med Univ Nac Cordoba 2016 ;73(4):297-301

Primary splenic angiosarcoma is an extremely agressive and rare neoplasm. Manifestations as bone marrow invasion and coagulation disorders have been reported isolatedly. A 26 years-old woman presented with abdominal pain; several anemia and thrombocytopenia associated to leukoerythroblastic reaction were found in the laboratory. Read More

Ann Intern Med 2016 08 22;165(3):226-7. Epub 2016 Mar 22.

Br J Haematol 2015 Jan 13;168(2):161. Epub 2014 Oct 13.

Department of Haematology, Ninewells Hospital, Dundee, UK.

Clin Colorectal Cancer 2014 Sep 23;13(3):e5-e11. Epub 2014 Jun 23.

Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA; Department of Medicine, Harvard Medical School, Boston, MA.

Blood 2014 Mar;123(12):1784

BMJ Case Rep 2014 Mar 12;2014. Epub 2014 Mar 12.

Department of Medicina I, Hospital Egas Moniz, Lisboa, Portugal.

BMJ Case Rep 2014 Mar 5;2014. Epub 2014 Mar 5.

Department of Pediatric Hematology and Oncology, Gaziantep Childrens' Hospital, Gaziantep, Turkey.

Megaloblastic anaemia due to vitamin B12 deficiency is rare in childhood. However, as most cases are due to maternal insufficiency, it is mainly seen in breastfed infants especially when the mother's socioeconomic status is low and the nutrition is not adequate. We present case of two Syrian refugee infants with severe vitamin B12 deficiency with pancytopenia, hepatosplenomegaly and leukoerythroblastosis. Read More

BMJ Case Rep 2014 Jan 31;2014. Epub 2014 Jan 31.

Cardiff University School of Medicine, Cardiff, UK.

The association of metastatic breast cancer presenting as thrombocytopenia and anaemia is demonstrated in the following case of a 79-year-old woman. Her main symptoms were abdominal pain, altered bowel habit and weight loss. Without a clear causative pathology, she underwent a CT scan which demonstrated multiple sclerotic bone lesions. Read More

Br J Haematol 2013 Aug 24;162(4):432. Epub 2013 Jun 24.

Department of Haematology, Hospital Ramón y Cajal, Madrid, Spain.

Am J Dermatopathol 2013 Apr;35(2):e34-6

Division of Dermatology and Cutaneous Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.

Background: While basal cell carcinoma (BCC) remains the most common skin cancer, the incidence of metastasis is rare. Most cases of metastatic BCC have been to regional lymph nodes. Metastasis to bone marrow with myelophthisic anemia is especially rare. Read More

Am J Hematol 2012 May 3;87(5):461-4. Epub 2012 Mar 3.

Pediatrics, Section of Hematology and Oncology, Baylor College of Medicine, 6701 Fannin Street, Houston, TX 77030-2399, USA.

Primary myelofibrosis is a chronic myeloproliferative neoplasm characterized by cytopenias, leukoerythroblastosis, extramedullary hematopoiesis, hepatosplenomegaly and bone marrow fibrosis. Primary myelofibrosis is a rare disorder in adults; children are even less commonly affected by this entity, with the largest pediatric case series reporting on three patients. Most literature suggests spontaneous resolution of myelofibrosis without long term complications in the majority of affected children. Read More

Am J Hematol 2012 May 26;87(5):520. Epub 2011 Sep 26.

Department of Paediatric Haematology, St Mary's Hospital, Praed Street, London, UK.

Indian J Pathol Microbiol 2011 Jul-Sep;54(3):659-60

Am J Hematol 2011 Jan;86(1):70-1

Ematologia/Coagulazione, Laboratorio di Chimica-Clinica, Ematologia e Microbiologia, Azienda Ospedaliera S. Antonio Abate, Varese, Gallarate, Italy.

Pathol Res Pract 2011 Feb 5;207(2):121-3. Epub 2010 Aug 5.

Haematopathology Residency Program, University of Toronto, Toronto, Canada.

Despite modern technological advancements in laboratory hematology, the blood film remains an important diagnostic aid. Herein, we report the case of a patient with a history of gastric cancer, who presented seven years following apparently successful surgery and adjuvant chemo-radio-therapy, with blood film findings of microangiopathic hemolytic anemia (MAHA), thrombocytopenia, and leukoerythroblastosis (LEB). Although mimicking features of thrombotic thrombocytopenic purpura (TTP), subsequent bone marrow examination instead revealed an association with occult recurrence of necrotic, metastatic gastric adenocarcinoma. Read More

Pediatr Blood Cancer 2010 Dec;55(6):1187-90

The Johns Hopkins University School of Medicine, Division of Hematology, Baltimore, Maryland, USA.

Ghosal hematodiaphyseal dysplasia syndrome (GHDD) is a rare clinical syndrome characterized by increased bone density and a severe, myelophthisic anemia. Few cases have been reported worldwide and there are no detailed descriptions of the associated hematologic abnormalities and long-term clinical outcomes after treatment. Here, we report two siblings with GHDD who were successfully treated with chronic, low dose, corticosteroid therapy. Read More

Int J Infect Dis 2010 Sep 6;14 Suppl 3:e379-80. Epub 2010 Jul 6.

Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009 Sep;108(3):e56-65

Department of Oral Medicine and Radiology, Meenakshi Ammal Dental College and Hospital, Chennai, India.

Osteopetrosis represents a heterogeneous group of rare, hereditary bone disorders with variable clinical features and an increase in bone density. The common clinical findings that usually lead to the detection of the disease are fractures and osteomyelitis of the mandible. We report 4 cases of osteopetrosis, complicated by osteomyelitis of the jaws. Read More

Indian J Pathol Microbiol 2009 Jul-Sep;52(3):363-7

Department of Hematology, VM Medical College and Safdarjung Hospital, New Delhi, India.

Normocytic anaemia is caused either by hypoproliferation of haemopoietic tissue or increased destruction of red cell. Osteopetrosis is a rare cause of anaemia. The leading clinical features are pallor, growth failure, hepatosplenomegaly. Read More

Int J Infect Dis 2009 Nov 23;13(6):e473-5. Epub 2009 Mar 23.

Department of Pediatrics, Trakya University Faculty of Medicine, 22030 Edirne, Turkey.

Background: Leukoerythroblastosis is characterized by the presence of leukocytosis and erythroid and myeloid blast cells in the peripheral blood. The most common etiological factors of leukoerythroblastosis occurring during early childhood are viral infections, juvenile myelomonocytic leukemia, and osteopetrosis. To our knowledge, an association with parvovirus B19 infection has only been reported in a preterm infant. Read More

Vet Clin Pathol 2008 Dec;37(4):403-8

Department of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, OK, USA.

A 14-year-old spayed American Paint mare was evaluated for mild colic, anorexia, pyrexia, and pancytopenia. Physical examination revealed mild tachycardia, tachypnea, and pale mucous membranes. Serial laboratory analyses revealed progressive pancytopenia, hyperfibrinogenemia, and hyperglobulinemia. Read More

Eur J Haematol 2008 May 23;80(5):448-51. Epub 2008 Jan 23.

Department of Internal Medicine, Division of Hematology, Mayo Clinic College of Medicine, Rochester, MN, USA.

Deficiency of vitamin B12 is a well known cause of megaloblastic anemia and pancytopenia. Splenomegaly and leukoerythroblastosis are much less well known manifestations of B12 deficiency. We report a B12 deficient female with severe pancytopenia including normocytic anemia who also had enlarged spleen and circulating nucleated red blood cells as well as circulating immature myeloid cells. Read More

J Tradit Chin Med 2007 Jun;27(2):143-7

Department of Histology, Embryology and Neurobiology, School of Basic Medical Sciences of Sichuan University, Chengdu 610041, China.

Objective: To study the effect of weiganli ([Chinese characters: see text]) on bone marrow hemopoiesis.

Methods: The effects of weiganli on the peripheral blood picture and the number of bone marrow nucleated cells (BMCs) were observed in myelosuppressed anemic model mice, and the effects of weiganli on the growth of colony forming unit-granulocyte macrophage (CFU-GM), colony forming unit-erythroid (CFU-E), burst forming unit-erythroid (BFU-E), colony forming unit-megkaryocyte (CFU-Meg) were investigated by in vitro cell culture technique. The hemopoietic stem cells (HSCs, c-kit+) in bone marrow were double stained with fluorescent antibody PE-C-Kit and FITC-CD45, and the HSCs (c-kit+) were counted by flow cytometer with CD45/SSC (side scatter) gating. Read More

Am J Hematol 2008 Jun;83(6):515-6

Department of Pathology, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia 08916, Spain.

Blood 2007 Mar;109(6):2666

Blood 2006 Aug 11;108(4):1158-64. Epub 2006 Apr 11.

Division of Hematology and Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.

We present results of 2 similarly designed but separate phase 2 studies involving single-agent lenalidomide (CC-5013, Revlimid) in a total of 68 patients with symptomatic myelofibrosis with myeloid metaplasia (MMM). Protocol treatment consisted of oral lenalidomide at 10 mg/d (5 mg/d if baseline platelet count < 100 x 10(9)/L) for 3 to 4 months with a plan to continue treatment for either 3 or 24 additional months, in case of response. Overall response rates were 22% for anemia, 33% for splenomegaly, and 50% for thrombocytopenia. Read More

Haematologica 2005 Nov;90 Suppl:ECR38

Celal Bayar University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology.

Leukoerythroblastosis is a rarely observed disease characterized by the presence of leukocytosis, erythroid and myeloid blast cells in peripheral blood. To our knowledge, it had not been diagnosed in a premature newborn before the case we report have.A female baby weighing 1164 grams, who was born prematurely at the 29th week of gestation by Cesarean section was referred to our newborn intensive care unit due to prematurity and respiratory distress with no prenatal pathological findings. Read More

Haematologica 2005 Jul;90(7):976-7

Six patients with bone marrow micrometastases from solid cancers presented with increased numbers of circulating CD34+ cells; the CD34+ cell counts were very high in some cases. By contrast, no patient with metastatic cancer without bone marrow involvement showed raised numbers of circulating hemopoietic progenitors. Read More

Am J Hematol 2004 May;76(1):92-3

Hematology and Medical Oncology, James Graham Brown Cancer Center, University of Louisville, Louisville, Kentucky 40202, USA.

Myelophthisis is a form of bone marrow failure due to replacement of hematopoietic tissue by abnormal tissue, most commonly metastatic carcinomas. This results in extramedullary hematopoiesis, typically in the spleen leading to premature release of hematopoietic cells into the circulation. Peripheral blood findings may include nucleated red blood cells, tear drop forms, giant platelets, and immature leukocytes. Read More

Br J Haematol 2003 Jul;122(1)

Department of Haematology, Royal Brompton and Harefield NHS Trust, Harefield Hospital, Harefield, UK.

Br J Haematol 2000 Sep;110(3):503

Department of Haematology, Histopathology & Internal Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh-160012, India.

Arch Pathol Lab Med 2000 Aug;124(8):1228-30

Division of Medical Oncology, University of Texas Medical Branch, Galveston 77555-0565, USA.

Rectal carcinoma is uncommonly associated with systemic metastases in the absence of liver metastases, reflecting the predilection for spread via the portal system. Occasionally, isolated lung metastases are seen, which are usually attributed to spread via the portosystemic anastomoses in the distal rectum. However, myelophthisis is an unreported complication of rectal cancer as an isolated form of systemic failure. Read More

J Am Anim Hosp Assoc 1999 Nov-Dec;35(6):471-3

North Coast Veterinary Specialist, Madison, Ohio 44057, USA.

Over a six-month period, 6% of 313 cats evaluated hematologically had either leukoerythroblastosis or normoblastemia. Diseases associated with these hematological conditions included haemobartonellosis, hepatic lipidosis, trauma, viral and bacterial infections, myeloproliferative disorders, and hemangiosarcoma. The finding of leukoerythroblastosis or normoblastemia may aid in diagnosing cats presenting with nonspecific signs. Read More

Intern Med 1998 May;37(5):480-3

First Department of Internal Medicine, School of Medicine, Ehime University.

We report a case of multiple diffuse fibrosarcoma of bone. The patient, a 38-year-old man, was referred to our hospital with knee pain, anemia and thrombocytopenia. No solid mass was seen on radiographic examination of the kneejoint, but magnetic resonance imaging showed hypointensity of the distal femur. Read More

Mund Kiefer Gesichtschir 1997 Mar;1(2):121-4

Klinik und Poliklinik für Zahn-, Mund- und Kieferheilkunde, Universität Köln.

Albers-Schönberg osteopetrosis, a rare heritable bone disease with autosomal dominant or recessive transmission, is generally characterised by diffuse sclerosis of the whole skeleton accompanied by pathological bone fragility and delayed physical development, profound intractable myelophthisic anaemia, neurological deficits, and osteomyelitis, especially of the jaws and the skull. The precise aetiology of the osteopetrosis is not clear. Therefore therapy is restricted to alleviation of symptoms. Read More

J Pediatr Hematol Oncol 1997 Mar-Apr;19(2):165-7

Division of Pediatric Hematology/Oncology, University of Texas Medical Branch, Galveston 77555-0361, USA.

Purpose: The diagnosis of transient erythroblastopenia of childhood (TEC) is usually straightforward, with temporary cessation of red blood cell production resulting in normocytic normochromic anemia, reticulocytopenia, and bone marrow erythroblastopenia. We describe here a case of TEC presenting with features of leukoerythroblastic anemia. To our knowledge, this is the first such report for TEC. Read More

J Inherit Metab Dis 1996 ;19(5):655-60

Division of Clinical Genetics, University of Toronto, Ontario, Canada.

We report a case of Farber lipogranulomatosis in a girl with hepatosplenomegaly, macular cherry-red spot, and subcutaneous nodules who developed liver dysfunction with jaundice and ascites, and myelophthisic anaemia because of infiltration of bone marrow with storage cells. Acid ceramidase assay confirmed the diagnosis. We conclude that the bone marrow dysfunction and cherry-red spot are features of type IV Farber lipogranulomatosis that have not been previously recognized, and should be added to the clinical phenotypic description. Read More

South Med J 1995 Jun;88(6):683-7

Department of Internal Medicine, Chang Gung Medical College, Chang Gung Memorial Hospital, Taipei, Taiwan, ROC.

Microangiopathic hemolytic anemia (MAHA) is a well-documented but rare complication of disseminated cancer; it usually occurs in the late or terminal stage of cancer. We describe a case of metastatic carcinoma of unknown origin in which MAHA was the initial presentation. A 36-year-old woman came to our hospital with lower back pain and progressive exertional dyspnea for 8 weeks. Read More

Hosp Pract (Off Ed) 1995 Apr;30(4):26

Department of Internal Medicine, Baylor College of Medicine, Houston, USA.

Br J Haematol 1995 Apr;89(4):911-3

First Department of Internal Medicine,University of Athens School of Medicine, Laikon General Hospital, Greece.

A case of adult osteopetrosis Type I was diagnosed in a 22-year-old female. She presented for investigation of anaemia with 'myelophthisic' characteristics and extramedullary haemopoiesis which was resistant to haematinics, nandrolone and low-dose corticosteroids. She became progressively transfusion-dependent with gradually worsening thrombocytopenia. Read More

South Med J 1994 Dec;87(12):1262-3

Department of Pathology, University of South Florida College of Medicine, Tampa.

We present the case of a 32-year-old white man seen for evaluation of pancytopenia 12 years after thoracolumbar myeloresection of intramedullary ependymoma. Bone marrow examination revealed extensive marrow fibrosis and tumor infiltrate compatible with metastatic ependymoma. Myelophthisic anemia due to metastatic ependymoma, though not previously reported, should be entertained in the differential workup for pancytopenia. Read More

J Am Vet Med Assoc 1993 Dec;203(12):1715-6

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Ohio State University, Columbus 43210-1089.

Thrombocytopenia in horses may be idiopathic or secondary to chronic infectious or inflammatory diseases (eg, equine infectious anemia, lymphosarcoma), drug administration, bone marrow depression, myelophthisic disease, or disseminated intravascular coagulation. This report describes EDTA-dependent pseudothrombocytopenia in a horse. Platelet counts for blood containing EDTA were consistently less than reference range, but platelet counts of blood containing heparin were within reference range. Read More

Clin Orthop Relat Res 1993 Sep(294):34-44

Department of Orthopaedic Surgery, Children's Hospital, Boston, MA 02115.

Osteopetrosis is an inherited skeletal condition characterized by increased bone radiodensity. There are three clinical groups: infantile-malignant autosomal recessive, fatal within the first few years of life (in the absence of effective therapy); intermediate autosomal recessive, appears during the first decade of life but does not follow a malignant course; and autosomal dominant, with full-life expectancy but many orthopaedic problems. The infantile variant shows a myelophthisic anemia, granulocytopenia, and thrombocytopenia, and patients eventually die from infection or bleeding or both. Read More

Cancer 1993 Jun;71(11):3594-600

Department of Medicine, University of Arizona College of Medicine, Tucson.

Background: The clinical and prognostic significance of leukoerythroblastic anemia (LKEA) in patients with metastatic prostate cancer and, in general, patients with disseminated solid tumors is poorly understood. Therefore, the authors studied a population of patients with metastatic prostate cancer refractory to hormonal therapy to assess the incidence, clinical features, and prognostic implications of LKEA.

Methods: The medical records of 106 patients with hormone-refractory prostate cancer metastatic to bone seen at the Tucson Veterans Affairs Medical Center between 1985 and 1991 were reviewed retrospectively. Read More

Recenti Prog Med 1993 Mar;84(3):168-76

Istituto di Clinica Medica Generale e Terapia Medica, Università, Ancona.

The Myelo-Dysplastic Syndromes are a heterogeneous group of diseases which includes patients with different prognosis. There is no agreement about the management and the therapeutic strategy must be based on many individual parameters, particularly the age of the patients and their performance status. The therapeutic options range from no cytotoxic therapy for low-risk patients up to more aggressive treatment for high-risk patients, with disappointing results except for the very few cases eligible for allogenic bone marrow transplantation. Read More

Lab Anim Sci 1993 Feb;43(1):37-47

Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens 30602.

The leishmaniases are global health problems that affect both humans and animals. The availability of nonhuman primate models is desirable for such important areas as testing candidate vaccines and newly developed chemo- and immunotherapeutic agents. Visceral leishmaniasis was experimentally induced in African green monkeys (Cercopithecus aethiops) by intravenously inoculating 10(7) amastigotes/kg of body weight of either Leishmania leishmania donovani of human origin (group 1) or L. Read More