Adult Leukemic Synovitis Is Associated With Leukemia of Monocytic Differentiation

Abstract

Adult leukemic synovitis occurs in association with leukemias of monocytic differentiation. Data presented here, and review of isolated case reports, support this association. The finding of large joint arthritis as a comorbidity in these 4 cases raises questions about the role of antecedent arthritis as a predisposing factor in the pathophysiology of leukemic synovitis.

Large granular leukemia with concurrent central nervous system and articular infiltration in a cat

“…Additionally, NK-cell leukemia was diagnosed in a patient with a 20 year history of rheumatoid arthritis (RA) that presented both neutropenia and splenomegaly, similar to our description [13]. Interestingly, in another study, a subset of leukemic patients reported former articular pain long before leukemia was diagnosed, raising the question about a potential role of initial arthritis as a triggering factor for subsequent neoplastic infiltration [14]. In the present report, this could be a possible explanation, for the presumed link between articular disorders and the development of LGL leukemia.…”

Leukemic arthritis and severe hypercalcemia in a man with chronic myeloid leukemia: a case report and review of the literature

“…The presence of blasts in the synovial fluid has been found in only a third of patients with LA [8]. The pathogenesis is thought to be leukemic infiltration into the synovial and peri-synovial tissues, such as the periosteum and capsule, which later leads to a synovial reaction, hemorrhaging into the joint from thrombocytopenia, and an immune complex-induced synovitis [2]. The treatment of choice for LA is definitive therapy for the underlying disease.…”

“…Leukemic arthritis (LA), a rare manifestation of CML, is more likely in the advanced stage of the disease [2]. Hypercalcemia associated with cancer is displayed by approximately 4% of patients with cancer, and it is mainly found in patients with solid tumors such as carcinoma (CA) of the lung, CA of the breast, and CA of the esophagus [3].…”

Acute lymphocytic leukemia mimicking spondyloarthritis in an adolescent: A case report and review of the literature

“…Acree et al (11) initially reported the association between adult LA and leukemia of monocytic differentiation. The study identified that four cases investigated in their study, and the majority of the prior reported cases of adult LA, were monocytic leukemia, indicating that adult LA occurs in association with leukemia of monocytic differentiation (11). Monocyte-attracting cytokines, including tumor necrosis factor α, have a significant role in osteoarthritis and rheumatoid arthritis via mediation of and increasing monocyte migration into the inflamed joint space.…”

“…Monocyte-attracting cytokines, including tumor necrosis factor α, have a significant role in osteoarthritis and rheumatoid arthritis via mediation of and increasing monocyte migration into the inflamed joint space. Acree et al (11) hypothesized that leukemic monocytes, identical to their benign counterparts, may migrate to sites of inflamed joints in response to monocyte-attracting cytokines, which may be critical in the mechanism of LA. Although the present case was not monocytic leukemia, there were significantly increased levels of monocytes (1.86x10 9 /l; 36.3%).…”