A Case Report: Acute Monocytic Leukemia Switching to Acute Erythroid Leukemia and Review of the Literature

Objective: Acute erythroid leukemia is rare.Clone switch in acute leukemia at relapse is an uncommom event,and therefore rarely reported in the literature.To improve the recognition of acute erythroid leukemia and mechanism of clone switch,here we report a case of acute monocytic leukemia switching to acute erythroid leukemia at relapse.Methods: To analyse a case of clone switch from acute monocytic leukemia to acute erythroid leukemia and get information at morphologic,cytogenetic and molecular levels during the treatment by some tests.Results: At initial diagnosis,the patient was acute monocytic leukemia.And switched to acute erythroid leukemia by analysis of results at morphologic,cytogenetic and molecular level after a cycle of chemotherapy.After another cycle of chemotherapy,the patient got a remission at morphologic level,and discharged.Afterwards,the patient gave up the treatment and died after 2 months.Conclusions: There would be two reasons to explain the clone switch: Firstly,the disorders come from the progenitor of red cells and monocytes,then cause the disease.As well,the disorders may come from impaired early hemapoietic stem cell(hsc),leading to the monocytic and erythropoietic abnormalities.Secondly,the changes of bone marrow microenvironment induced erythroid abnormalities which lead to acute erythroid leukemia.In this case,the disease may have abnormalities in early hematopoietic stem cells,and the bone marrow microenvironment played an important role in the process of the disease.The results need to affirmed by further clinical observation and further researches.It remind us that dynamic diagnosis and consciousness of treatment need to improved,Which will contribute to the prevention,diagnosis and treatment of acute leukemia.