Acute erythromyelosis that developed after chemoradiotherapy for two solid tumors. Description of the clinical case

The clinical case description presents an observation of a rare form of acute myeloblastic leukemia (erythromyelosis, M-6 variant, C94. 0 according to the ICD). A special feature of the clinical case is its development in a patient after previous radiation and multicomponent chemotherapy for cancer of the left breast and cancer of the right ovary. Morphological atypiа of blast cells did not allow to immediately establish a cytomorphological diagnosis of acute erythromyelosis. The correct diagnosis was made possible after a cytochemical study of bone marrow blasts, which revealed a bright RAS-positive reaction in a granular form. Further immunophenotypic study of blast cells allowed us to confirm their myeloid orientation within the framework of myelodysplastic syndrome. An expanded panel of immunophenotypic diagnostic markers, including CD71, CD105, confirmed the high expression of these antigens on tumor cells. This confirmed the myeloid orientation of the blasts, namely erythromyelosis. Taking into account the severity of the patient’s clinical condition, she underwent a reduced course of 7 + 3, in combination with replacement blood transfusion therapy with erythrocyte mass and platelet concentrate. In connection with the signs of esophagitis, antibacterial and antifungal drugs were prescribed. Due to an increase in the level of transaminases, hyperbilirubinemia (direct fraction), a decrease in total protein, and an extension of the prothrombin time in the coagulogram, transfusions of freshly frozen plasma were performed to correct these disorders.