Chronic lymphatic leukemia terminating in acute myeloid leukemia: Review of the literature

Stern, Naftali; Shemesh, Joseph; Ramot, Bracha

doi:10.1002/1097-0142(19810401)47:7<1849::aid-cncr2820470722>3.0.co;2-x

Cited by 36 publications

(16 citation statements)

References 28 publications

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“…In those patients who have received cytotoxic therapy, a number of workers have referred to the known leukemogenic effects of alkylating agents and other chemotherapeutic or radiologic treatments (3-5, 10,14,18,20). In reports of patients developing acute leukemia following CLL, with or without treatment, frequent reference is made to the high incidence of secondary malignancies due to reduced immune competence (1, 2, 5, 10,11,14,15,17,18,20). In these patients, the onset of the more aggressive AML may call attention to an indolent, clinically asymptomatic CLL (5, 10, 1 1 ).…”

Section: Discussionmentioning

confidence: 99%

“…To our knowledge, 18 cases have been reported since 1970 where CLL and acute myeloid leukemia (AML) or myeloproliferative disorder were detected simultaneously (1-3, 5, 9-1 1, [13][14][15][16][17][18][19]. A larger number of the reported cases are associated with cytotoxic treatment of CLL and the subsequent detection (or development) of acute myeloid leukemia ( 4 2 0 ) .…”

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Two color flow cytometric analysis of concomitant acute myeloid leukemia and chronic lymphocytic leukemia

et al. 1994

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Key terms: Concomitant leukemia, two-color flow cytometry, immunophenotypingThe development of acute leukemia during the course of chronic lymphocytic leukemia (CLL) is rare but is being reported with increasing frequency. To our knowledge, 18 cases have been reported since 1970 where CLL and acute myeloid leukemia (AML) or myeloproliferative disorder were detected simultaneously (1-3, 5, 9-1 1, [13][14][15][16][17][18][19]. A larger number of the reported cases are associated with cytotoxic treatment of CLL and the subsequent detection (or development) of acute myeloid leukemia ( 4 2 0 ) . We report a case of simultaneous detection of CLL with AML and demonstrate the use of two-color flow cytometry in the discrimination of the two malignant cell types. CASE REPORTA 74-year-old woman was referred to UNC Hospitals, Chapel Hill, NC, with macrocytic anemia, thrombocytopenia, leukocytosis, fatigue, shortness of breath, and a 20 pound weight loss during the preceding 6 months.Two weeks prior to admission she presented to her local emergency room with blood specks in her sputum. She was noted to have a decreased hematocrit with an increased mean corpuscular volume (MCV), which was refractory to multiple vitamin B-12 injections. Past medical history was remarkable for non-insulin dependent diabetes mellitus, hypertension, and recurrent urinary tract infections. Past surgical history included bilateral breast reduction and total abdominal hysterectomy. On physical examination the patient appeared well. She had a few 0 1 9 9 4 Wiley-Liss, Inc.small petechiae on her palate, abdomen, and legs. N o lymphadenopathy or hepatosplenomegaly was noted. Rectal exam showed trace guaiac positive stool. Laboratory data included the following complete blood count (CBC) results: hematocrit 17%, hemoglobin 5.6 gdl, platelets 29 X 107/L, and white blood cells (WBC) 15.6 X 107/L. The white blood cell differential showed 3% neutrophils, 7596 lymphocytes, 2% monocytes, < 1 o/u eosinophils, 1 % basophils, and 19% peroxidase-negative (large unstained cells, "LIJC").A diagnostic bone marrow aspirate and biopsy were performed and a portion of the aspirate material was submitted for flow cytometric analysis. Results of these studies were positive for both acute myeloid leukemia and chronic lymphocytic leukemia.The patient's hospital course was relatively uncomplicated. She was started on a chemotherapeutic regimen of vincristine and prednisone. A more rigorous induction chemotherapeutic regimen was not attempted due to the patient's age. Supportive therapy with packed red blood cells and apheresis donor platelets was given as needed over the following 2 months.

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Section: Discussionmentioning

confidence: 99%

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Two color flow cytometric analysis of concomitant acute myeloid leukemia and chronic lymphocytic leukemia

et al. 1994

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“…Since rare cases of AML or MDS occurring concurrently with or after untreated CLL have been reported [1,, an apparent question is whether the co-existence of AML and untreated CLL was merely a coincidence or the two diseases were clonally related. Although karyotypes were available in some reported cases [11,[13][14][15]23,25], in none were the two leukemic cell populations separated for cytogenetic analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Rare cases of acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) occurring in patients with chronic lymphocytic leukemia (CLL) have been described, with the majority being treatment-related and having unfavorable karyotypes [1][2][3][4][5]. There are approximately 30 cases of AML occurring concurrently with or after untreated CLL in the literature since the 1970s [1,, 17 of which contain immunophenotypic data [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26].…”

Section: Introductionmentioning

confidence: 99%

“…There are approximately 30 cases of AML occurring concurrently with or after untreated CLL in the literature since the 1970s [1,, 17 of which contain immunophenotypic data [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. Nevertheless, none of the previous reports drew a conclusion regarding whether AML and CLL cells share the same clonality in those patients.…”

Section: Introductionmentioning

confidence: 99%

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Concurrent acute myeloid leukemia with inv(16)(p13.1q22) and chronic lymphocytic leukemia: Molecular evidence of two separate diseases

Murata-Collins²,

Wang

et al. 2006

American J Hematol

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Acute myeloid leukemia (AML) occurring concurrently with or after untreated chronic lymphocytic leukemia (CLL) is rare. We report a case of a 59-year-old man who was evaluated for anemia, thrombocytopenia, and leukocytosis with circulating blasts. On the basis of the morphology and immunophenotyping results, a preliminary diagnosis of chronic myelomonocytic leukemia with concurrent CLL was considered. Subsequently, cytogenetic analysis of the leukemic blood specimen revealed inv(16)(p13.1q22) with secondary trisomy 22 in a sideline clone. Fluorescence in situ hybridization confirmed the CBFb rearrangement associated with inv(16) in myeloblasts and myelomonocytic cells, but not in CLL cells. Therefore, a final diagnosis of AML with inv(16) with concurrent CLL was made. After standard chemotherapy for AML, the patient achieved complete remission for both his AML and CLL. The unique aspects of this case include concomitant AML and CLL, which do not share clonality, complex cytogenetic abnormalities with trisomy 22 as a secondary abnormality associated with inv(16), and achievement of remission for both AML and CLL by AML chemotherapy regimen. This case also represents one of the rare instances where a diagnosis of AML can be established even when the blast percentage in the marrow and blood is less than 20%. Am. J. Hematol. 81:963-968, 2006. V V C 2006 Wiley-Liss, Inc.

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Optic Neuropathy in Chronic Lymphocytic Leukemia

Currie

Lessell

et al. 1988

Archives of Ophthalmology

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Chronic lymphatic leukemia terminating in acute myeloid leukemia: Review of the literature

Cited by 36 publications

References 28 publications

Two color flow cytometric analysis of concomitant acute myeloid leukemia and chronic lymphocytic leukemia

Two color flow cytometric analysis of concomitant acute myeloid leukemia and chronic lymphocytic leukemia

Concurrent acute myeloid leukemia with inv(16)(p13.1q22) and chronic lymphocytic leukemia: Molecular evidence of two separate diseases

Optic Neuropathy in Chronic Lymphocytic Leukemia

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