Pure Red Blood Cell Aplasia and Chronic Lymphocytic Leukemia

Acquired pure red blood cell (RBC) aplasia (PRCA) is a rare hematologic disorder characterized by anemia, absence of reticulocytosis, erythroid hypoplasia in the bone marrow, and no abnormalities of the myeloid and megakaryocytic lines.^1,2 The anemia is severe and generally normochromic and normocytic. Approximately 50% of adults with PRCA have thymomas.^3-5 It has also been associated with a variety of disorders including neoplasms,⁶ preleukemic states,^1,7 riboflavin deficiency,⁸ renal failure,⁹ and exposure to drugs.¹⁰ Pure RBC aplasia has been reported also in adults who have no other medical disorders or history of exposure to toxins.²

Dameshek and colleagues have referred to occasional cases of chronic lymphocytic leukemia in which the anemia was associated with erythroblastopenia and reticulocytopenia.⁴ Tatarsky¹¹ and Stohlman et al¹² have recently described PRCA as a rare cause of anemia in chronic lymphocytic leukemia. Our report describes a