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. 2012 Oct-Dec;5(Spec Issue):6-11.

Chronic lymphocytic leukemia followed by myelodysplastic syndrome and erythroleukemia

O Cazaceanu  1 , A Iova  1 , A M Vladareanu  1 , M Onisai  1 , C Enache  1 , E Andrus  1
Affiliations

Chronic lymphocytic leukemia followed by myelodysplastic syndrome and erythroleukemia

O Cazaceanu et al. J Med Life. 2012 Oct-Dec.

Abstract

CLL patients are more exposed to develop a second neoplasm, but the association. CLL-MDS is an unusual one. We present the case of a 61-year-old male patient, diagnosed with chronic lymphocytic leukemia in 2007, who developed myelodysplastic features three years later and then acute myeloid leukemia. At diagnosis, the blood tests showed leucocytosis, with lymphocytosis in the peripheral blood and bone marrow. Due to the negative prognostic factors, the patient received treatment with an alkylating agent (FC protocol) and then with alemtuzumab. Three years after being diagnosed with CLL, the patient presented with malaise, recent faintness and fever, with severe anemia and thrombocytopenia. The results from the bone marrow aspirate and biopsy established a new diagnosis: myelodysplastic syndrome. The patient's general condition was rapidly deteriorating and just two months later, he evolved into acute myeloid leukemia, subtype 6, a very rare type of AML. Soon after, neurological alterations led to cerebral hemorrhage and death. A review of literature is also presented.

Keywords: chronic lymphocytic leukemia; erythroleukemia; myelodysplastic syndromes; second malignant neoplasms.

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Figures

Fig. 1
Fig. 1
Lymphocytes and smudge cells
Fig. 2-3
Fig. 2-3
Immunophenotyping peripheral blood; FACS –Calibur acquisiyion, CellQuest software.
Fig. 4
Fig. 4
Erythroblasts with megaloblasatic features
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Fig. 5
Myeloblasts
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Fig. 6
Erythroblast with Jolly bodies
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Fig. 7
Neutrophils with hyp ogranularity and Pelger-Huet abnormalities
Fig. 8-11
Fig. 8-11
Immunophenotyping the bone marrow; FACS –Calibur acquisiyion, CellQuest software
Fig. 12
Fig. 12
Erythroblasts with two nuclei
Fig. 13
Fig. 13
Myeloblasts
Fig. 14-15
Fig. 14-15
Erythroblasts PAS positive
See this image and copyright information in PMC

References

    1. Wintrobes Clinical Hematology 12th 2009.
    1. Lai R, Arber DA, Brynes RK, Chan O, Chang KL. Untreated chronic lymphocytic leukemia concurrent with or followed by acute myelogenous leukemia or myelodysplastic syndrome. A report of five cases and review of the literature. Leuk Lymphoma. 2005 Jan;46(1):49–54. - PubMed
    1. Foucar K, McKenna RW, Bloomfield CD, et al. Therapy-related leukemia: a panmyelosis. Cancer. 1979;43:1285–1296. - PubMed
    1. Müller-Hermelink HK, Montserrat E, Catovsky D, et al. Chronic lymphocytic leukaemia/small lymphocytic lymphoma. In: Swerdlow SH, Campo E, Harris NL, editors. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. 4th ed. Lyon, France: International Agency for Research on Cancer; 2008. pp. 180–182.
    1. Hallek M, Cheson BD, Catovsky D, et al. Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia: a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer Institute-Working Group 1996 guidelines. Blood. 2008;111:5446–5456. - PMC - PubMed

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