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Coexistence Of Chronic Lymphocytic Leukemia And Acute Myeloid Leukemia.

Coexistence Of Chronic Lymphocytic Leukemia And Acute Myeloid Leukemia.
Author Information (click to view)

Milosevic I,


Milosevic I, (click to view)

Milosevic I,

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Turkish journal of haematology : official journal of Turkish Society of Haematology 2016 Oct 18() doi 10.4274/tjh.2016.0106
Abstract

A 76-years old man presented with leucocytosis (86×109/l), fever, pneumonia and significant weight loss. He had a history of chronic lymphocytic leukemia diagnosed five years earlier and he responded with partial remission to the treatment with continuous low doses of chlorambucil. Analysis of blood smear, bone marrow aspiration and bone marrow biopsy revealed predomination of small lymphocytes, but 22% of cells were blasts negative to cytochemical stainings (Figure 1). Flow cytometric analysis showed two distinct populations: 65% of cells was small to moderate in size, CD19+, CD45+, CD5+, CD20+/-, but 30% of cells were large, CD34+, CD13+, HLA DR+, CD65+, CD45+, MPO weakly positive and CD33, CD14, CD15, CD16 negative. Immunophenotyping confirmed coexistence of chronic lymphocytic leukemia and poorly differentiated acute myeloid leukemia. Conventional cytogenetic testing did not show any chromosomal abnormalities. Patient was treated with intensive antibiotics and received one course of chemotherapy, but did not achieve remission and died two months later. Coexistence of chronic lymphocytic leukemia and acute myeloid leukemia is rare (1). Therapy-related acute myeloid leukemia can develop after treatment of chronic lymphocytic leukemia with alkylating agents, nucleoside analogs or with combination chemotherapy, but two leukemias can also originated independently (2,3).

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