Case 1. The patient, a fifty-four year old man, was admitted to the Niigata University Hospital because of anemia and gingival bleeding in november 1970. Physical examination on admission showed slight enlargement of the liver. White blood cell count was 25, 200 with 54% of monocytoid cells. The bone marrow puncture revealed marked proliferation of monocytoid cells (71.4%). PAS reaction of the erythroblasts was negative. The nucleated erythroblasts were seen in the peripheral blood at the rate of 10 per 200 WBC during the course. The treatment was ineffective and the patient died because of gastrointestinal bleeding on November 16, 1971. Both clinical and pathological diagnoses were myelo-monocytic leukemia (Naegeli type).
Case 2. The patient, a 29 year old woman, had an onset of anemia and pneumonia in December 1969. She was admitted to the Niigata University Hospital in February 1970. Physical examination on admission showed anemia and hepatosplenomegaly. White blood cell count was 44, 000 with 85% of monocytoid cells. The bone marrow puncture showed marked proliferation of monocytoid cells (73.2%). PAS reaction of the erythroblasts was positive. The marked increase of the erythroblasts was seen in the peripheral blood at the rate of 195per 200 WBC during the course. The patient died because of bacterial infection in August 1971. Clinical diagnosis was erythro-leukemia (di Guglielmo syndrome) but the autopsy could not be performed.
It is presumed that proliferation of the erythroid series, associated with absolute monocytosis, might be one of the causes of the relatively chronic course.
