Coexistence of Myeloid and Lymphoid Neoplasms: A Single-Center Experience

Abstract

The coexistence of a myeloid and a lymphoid neoplasm in the same patient is a rare finding. We retrospectively searched the records of the Hematology Division of the Second Department of Internal Medicine and Research Institute at Attikon University General Hospital of Athens from 2003 to 2018. Nine cases have been identified in a total of 244 BCR-/ABL1- negative MPN and 25 MDS/MPN patients and 1062 LPD patients referred to our institution between 2003 and 2018. Each case is distinct in the diversity of myeloid and lymphoid entities, the chronological occurrence of the two neoplasms, and the patient clinical course. All of them exhibit myeloproliferative (6 JAK2 V617F-positive cases) and lymphoproliferative features, with 1 monoclonal B-cell lymphocytosis (MBL), 3 B-chronic lymphocytic leukemias (B-CLL), 3 B-non-Hodgkin lymphomas (B-NHL), 1 multiple myeloma (MM), and 1 light and heavy deposition disease (LHCDD), while in three cases myelodysplasia is also present. The challenges in identifying and dealing with these rare situations in everyday clinical practice are depicted in this article.

Co-Occurrence of Myeloid and Lymphoid Neoplasms: Clinical Characterization and Impact on Outcome. A Single-Center Cohort Study

“…Biologically, it has been speculated that the co-occurrence of myeloid and lymphoid neoplasms may be sustained by a common clonal progenitor ( 13 , 14 ). This could be assumed particularly in MPN patients with a demonstrated driver mutation, preceding LPD onset.…”

Does Double Mean Trouble? Coexistence of Myeloproliferative and Lymphoproliferative Neoplasms

“…During follow-up treatment, 35% of patients died due to the progression of LPDs (two patients), heart failure (one patient), renal failure (one patient) and COVID-19 (one patient). 3 1 MM 7 + PMF 5 2 CLL 6 /PV 3 1 atypical CLL 6 (score 3)/PMF 5 5 PV 3 + CLL 6 2 PMF 5 + CLL 6 1 ET 8 + CLL 6 1 PMF 5 + MM 7 1 ET 8 + MM 7 1 PV 3 + MM 7 1 PMF 5 + NHL DLBCL 4 1 PV 3 + NHL DLBCL 4 1 PV 3…”

“…Occurrence of two distinct hematology neoplasms in the same patient is very rare; therefore, little is known in regard to the clinical characteristics, thrombotic complications and survival chances of this scenario. Considered etiopathogenetic mechanisms, some genetic abnormalities ( JAK2V617F , BCR/ABL1 , PDGFRA , PDGFRB , TET2 , SF3B1 ) were described which can lead to either myeloid or lymphoid malignancies [ 6 , 7 , 8 ]. A Swedish registry study revealed a 5- to 7-fold elevated risk of MPNs and a 1.6-fold increased risk of CLL among first-degree relatives of MPN patients [ 9 ].…”

Exploring the molecular mechanisms between lymphoma and myelofibrosis

“…The association of lymphoma and MF in the same patient is a relatively uncommon event, described mostly sporadically in case reports. Biologically, it has been speculated that the co-occurrence of myeloproliferative neoplasms (MPNs) lymphoma may be sustained by abnormal cloning and genetic changes of early hematopoietic progenitor cells [6,7]. A report by Rumi et al described that the increased risk of lymphoproliferative neoplasms (LPN) in MPN Am J Transl Res 2024;16(3):730-737 patients may be multi-factorial, including genetic susceptibility (i.e., p53, VHL, SNPs), acquired mutations (JAK2V617F), and impaired immune monitoring [8,9].…”