Acquired hemoglobin H disease in a case of refractory anemia with excess of blasts (RAEB) evolving into acute nonlymphoid leukemia.

A new case of refractory anemia with excess of blasts (RAEB) with acquired Hemoglobin H disease (HbH) evolving into acute nonlymphoid leukemia (ANLL) is reported. In this patient, both family and personal history were negative for alpha thalassemia. At time of diagnosis of RAEB, 'golf ball' erythrocytic inclusions, typical of HbH, were found. The cellulose acetate electrophoresis (pH 8.9) revealed a fast moving band, corresponding to HbH. An evolution into ANLL, M1 subtype, 25 months later, has been documented.