A 64-year-old woman is reported with Stage I (Rai) chronic lymphocytic leukaemia (CLL), in whom hypercalcemia developed when an increased proportion of prolymphocytic cells characterized a transformation of CLL in prolymphocytoid leukaemia (CLL/PL). Although hypercalcemia is more frequently found in T-cell leukaemia associated with human T lymphotropic lymphocyte type I, scattered reports indicate that patients with B-CLL can also be affected with this metabolic disturbance. The case described here, progressed with an indolent course of CLL for 26 months, when she was admitted with a very aggressive disease characterized by a high WBC count, splenomegaly and hypercalcemia. Despite an effort to achieve a clinical remission, she failed treatment and death was attributed to unresponsive hypercalcemia. The mechanism of hypercalcemia in such cases is unclear as no parathyroid adenoma or second malignant tumor was found ante mortem. This electrolytic disturbance would appear to be a direct consequence of the transforming leukaemia and a possible mechanism involving a secreted humoral factor that could lead to altered calcium metabolism.
Desde o descobrimento e caracterização do retrovírus (HTLV-i) e a sua associação com algumas neoplasias de células T periféricas, muitos avanços foram alcançados quanto aos aspectos etiopatológicos da leucemia/linfoma T do adulto (LLTA). Estudos soroepidemiológicos anti-HTLV-I realizados em diversas partes do mundo demonstraram que: HTLV-I é o agente etiológico da LLTA e da paraparesia espástica tropical (TSP); LLTA tem uma característica peculiar que é a forma geográfica da incidência da doença; na sua forma clínica mais freqüente, a LLTA pode apresentar as mesmas características dos linfomas cutâneos. Com o objetivo de divulgar os aspectos clinico patológicos dessa doença descrevemos a nossa experiência, ao estudar 21 casos de LLTA diagnosticados no Laboratório de Marcadores Celulares (CEMO) selecionados entre 260 casos de doenças linfoproliferativas crônicas, ao mesmo tempo que fazemos uma revisão de literatura sobre os avanços alcançados nas pesquisas dessa doença.
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