Background: Monoclonal gammopathy of undetermined significance (MGUS) progresses to plasma cell dyscrasia at a rate of 1% per year. A high prevalence of MGUS has been noted in series of patients with immune disorders or chronic infections.
Methods: Retrospective cohort and a cross-sectional study to analyze the prognostic value of aberrant (CD38(+ +)CD138(+) CD19(-)CD45(weak)) to normal phenotype (CD38(+ +)CD138(+) CD19(+)CD45(+)) bone-marrow plasma cells ratio (A/N ratio) for the development of a plasma cell dyscrasia and the association with the presence of a chronic immune disorder.
Erythrophagocytosis by neoplastic cells in acute leukemia has been most frequently associated with FAB M4 and M5 subtypes, with the t(8;16) and with C-MOZ rearrangements, however it is exceptional in acute lymphoblastic leukemia and has not been previously reported in Philadelphia-positive (Ph+) acute leukemia. We herein present a case of Ph+ acute leukemia of ambiguous lineage in which erythrophagocytosis is an outstanding feature. The implications between the different postulated leukemogenic pathways and the hypothesized mechanism of erythrophagocytosis are concisely reviewed and discussed.
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