MRCP revision battle 54.6: Leukoerythroblastic change

Leukoerythroblastic change is the term used to describe nucleated red cells and primative white cells in the peripheral blood.


Causes of leukoertythroblastic change can be split into 2 catagories:

1. Invasion of bone marrow space

• metastatic carcinoma
• leukaemia
• myeloma
• lymphoma
• myelofibrosis
• Gaucher's disease (covered in next battle)

2. Severe illness


Leukoerythroblastic change may be indicated by:

• high leucocyte alkaline phosphatase
• Dohle bodies = blue leucocyte inclusions in peripheral cytoplasm of neutrophils
• left shift of neutrophils = younger neutrophils than normal -->less nuclei

As an aside, Dohle bodies are also seen in burns, infection and trauma.


Now for the final short skirmish, Gaucher's disease...