Concomitant chronic lymphocytic leukemia and acute myeloid leukemia with an uncommon immunophenotype

Abstract

We report a case of simultaneous diagnosis of chronic lymphocytic leukemia (CLL) and acute myeloid leukemia (AML), in which the use of flow cytometry analysis allowed the demonstration of two different cell populations and the study of both immunophenotyp-ing patterns with a large panel of monoclonal antibodies (MoAbs). CLL cells showed a typical immunophenotype with coexpression of B cell markers with CD5, CD23, CD43, and weak surface immunoglobulin light chain restriction expression, whereas the AML population had a very uncommon phenotype with expression of myeloid markers and CD56 and lack of expression of other natural killer (NK) antigens, CD34 and HLA-DR. After chemotherapeutic treatment of AML with two induction courses, the patient achieved complete remission of the AML with persistence of a CD19/CD5 positive population. After consolidation chemotherapy, this latter population was no longer detectable despite the presence of lymphoid nodules in a bone marrow biopsy. Six months after diagnosis, the patient relapsed with AML and died shortly afterwards. Am.

Treatment-related acute myeloid leukemia in a chronic lymphocytic leukemia patient: role of fludarabine?

“…Therapy-related acute monoblastic leukemia (M5) in CLL, as in the present case, has rarely been reported [Lavabre-Bertrand et al 1989]. Our review of previously published cases demonstrates that AML and CLL may be diagnosed concurrently or after a variable latency period (<2-13 years) [Bracey et al 1989;Robertson et al 1994;Mateu et al 1997;Meloni et al 2000;Molero et al 2001;Lam et al 2005;Lu et al 2006;Hatoum et al 2007;Park et al 2009]. Rarely, the development of AML may not manifest with peripheral circulating blasts [Robertson et al 1994].…”

Concomitant presentation of acute myeloid leukemia with T-cell large granular lymphocytic leukemia

“…Chemotherapy of secondary AML or MDS is associated with poor results [10,17], although, Mateu et al report a case of simultaneous B-cell CLL and AML successfully treated with AMLspecific induction chemotherapy [6]. There is a general consensus that in secondary AML, chemotherapy specific for this leukemia should be proposed only for patients with favorable karyotypes, younger age, and good performance status [10,17].…”

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

“…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. Nevertheless, in one case, chromosome aberrations commonly associated with both CLL (e.g.…”

“…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.…”