Gene probe analysis demonstrates independent clonal evolution of co‐existent chronic myeloid and chronic lymphocytic leukaemia

Abstract

We describe a case of Philadelphia‐positive chronic myeloid leukaemia occurring simultaneously with B‐cell chronic lymphocytic leukaemia in a 69‐yr‐old male. Gene probe analysis of DNA from both peripheral blood and bone marrow provided evidence for the independent evolution of 2 clones in this case, with a predominant population showing immunoglobulin heavy chain gene rearrangement and a smaller population showing a rearrangement within the breakpoint cluster region of chromosome 22.

The coexistence of chronic lymphocytic leukemia and myeloproliperative neoplasms: A retrospective multicentric GIMEMA experience

“…To our knowledge, the series described in the present retrospective multicentre study is the largest so far reported in the literature: a total of 46 patients affected by CLL/MBL and concomitant MPN, followed by 15 Italian GIMEMA centers were analyzed in this study. In comparison with data emerging from the cases reported in the literature, we observed a lower incidence of CML (19.5% vs. 46.6%) [7–30] and PV (21.7% vs. 32%) [34, 35, 40–53], and a higher incidence of ET (39.2% vs. 21.4%) [31–39] and PMF (13% vs. 1.7%) [54]. In addition, we detected for the first time 3 cases (6.6%) of CLL associated with atypical CML (MPN/MDS).…”

“…The spectrum of secondary solid neoplasms during the course of CLL includes carcinomas of the skin, stomach, colon, breast, or kidney [4, 5]; among secondary hematologic malignancies, cases of acute lymphocytic, myelocytic, monocytic and myelomonocytic leukemia, erythroleukemia, plasma cell leukaemia [6], and myeloproliferative neoplasms (MPN) have been reported [7–54].…”

“…In fact, most of the reported cases are purely anecdotal and merely descriptive. In a review of the literature, we found 25 cases of CLL/chronic myeloid leukemia (CML) [7–30], 18 cases of CLL/polycythemia vera (PV) [34, 35, 40–53], 12 cases of CLL/essential thrombocythemia (ET) [31–39], and only one case of CLL with primary myelofibrosis (PMF) [54].…”

“…The clonal origin of these neoplasms was investigated in some of the cases. Most of these studies described distinct genetic events in the myeloid and lymphoid cell populations, documented by cytogenetics, fluorescence in situ hybridization (FISH) and/or molecular analysis, suggesting the independent origin of the two diseases in unrelated clones [7, 11, 14–19, 23, 26].…”

“…The pattern of onset of the two neoplastic disorders is extremely heterogeneous and appears to depend on the type of concomitant MPN. Among the 25 CLL/CML cases reported in the literature [7–30], in most (52%) the diagnosis of MPN followed the diagnosis of CLL [18–29], in 7 (28%) the two diseases were diagnosed concomitantly [11–17] and in 5 (20%) the diagnosis of CML preceded that of CLL [7–10, 30]. In contrast, in none of 12 CLL/ET cases the diagnosis of ET followed the diagnosis of CLL [31–39].…”