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Logo of procrsmedFormerly medchtJournal of the Royal Society of MedicineProceedings of the Royal Society of Medicine
 
Proc R Soc Med. 1939 September; 32(11): 1429–1434.
PMCID: PMC1998069

Leukopenic Myelosis

(Section of Medicine)

Abstract

The term “leukopenic myelosis” is used to describe a type of “myeloblastic leukæmia” in which the leukocyte content of the peripheral blood is subnormal for the whole or the greater part of the course of the disease. Separation from the frankly leukæmic cases is made only on the grounds of clinico-hæmatological convenience.

Twenty-two cases have been seen in the past four years. The age-incidence varied from 3-73 years; 10 were in males and 12 in females. Acute, subacute, and chronic types may be recognized. In all the main characteristic is a progressive anæmia; in acute cases hæmorrhagic phenomena and necrotic angina are common.

The blood-count is characterized by orthochromic or hyperchromic anæmia, sometimes with reticulocytosis and erythroblastosis. Leukopenia may persist throughout the course, or a terminal leukæmia may occur—especially in the chronic cases. The features of the differential count are the presence of myeloblasts—although the percentage may be below 5%—and the hiatus leukæmicus. Thrombocytopenia usually means a rapid course.

This clinico-hæmatological picture may be mimicked more or less closely by pernicious anæmia, aplastic anæmia, agranulocytosis, and the leuko-erythroblastic anæmias. The sternal puncture findings are, however, diagnostic, and show a great preponderance of primitive myeloid cells, most frequently with a predomincnce of myeloblasts. In two cases evidence was found that the erythropoietic tissues shared in the hyperplasia.

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