Simultaneous Occurrence of B-Cell Lymphocytic Leukemia and Acute Myeloid Leukemia in an Elderly Female Patient

Abstract

Introduction: The coexistence of B-cell chronic lymphocytic leukemia (CLL) and acute myeloid leukemia (AML) in the same patient is rare. The aim of this study is to report of simultaneous occurrence of CLL and AML M5 in an old female patient for the first time. Case Presentation: A 72-year-old woman referred to hematology clinic for evaluation of leukocytosis, anemia, and thrombocytopenia. She had no known history of chronic illness or exposure to radiation or myelotoxic drugs. Physical examination showed the existence of generalized lymphadenopathy and splenomegaly. Section of the biopsy core disclosed a diffuse infiltration of lymphoid cells with hyperchromic irregular nuclei and scant cytoplasm in the background. Immunohistochemical staining for CD20 in lymphoid cells and CD68 in blastic cells were positive but it was negative for terminal deoxynucleotidyl transferase (TdT). The flow cytometric immunophenotyping analysis was performed in the presence of CD5 positive B-cell population (CD19; CD20 dim; CD23 and CD5/CD19) with small cell size that comprised 76% of cells with abnormal phenotype was revealed. Simultaneous occurrence of CLL and AML M5 was confirmed in the patients. Conclusions: We report a case of previously untreated CLL and AML M5 with rapidly progressive course to death in less than one month from diagnosis. To the best of our knowledge, the development of AML M5 in patient with CLL has not been reported before.