Myelodysplastic syndrome associated with erythrophagocytosis by blasts and myeloid cells

A 63-year-old man with refractory anemia with excess of blasts in transformation exhibited erythroid hyperplasia, dyserythropoiesis, a del(20q) abnormality, susceptibility to bacterial infections, and a relatively short survival. Phagocytosis of erythrocytes by blast cells was observed. Erythrophagocytosis was also seen in myeloid cells, including promyelocytes, myelocytes, metamyelocytes and neutrophils. Neither the monocytes nor the macrophages showed erythrophagocytosis. This is the first report of erythrophagocytosis by blasts and myeloid cells in a patient with myelodysplastic syndrome.