High risk myelodysplastic syndrome coexistent with chronic lymphocytic leukemia for more than 9 years: inhibition of the myeloid clone by the lymphoid clone?
We describe a patient in whom the concomitant diagnosis of refractory anemia with excess of blasts (16% on initial marrow examination) and chronic lymphocytic leukemia was made more than 9 years ago. The myeloid clone showed a complex karyotypic abnormality. Evolution has so far been remarkably stable, without transformation into acute leukemia. Clonogenic assays showed that patient's serum inhibited the patient's own granulocyte-macrophage colony-forming units (CFU-GM). This inhibition was also present for a control subject's CFU-GM and acute myeloid leukemia clonogenic cells. This raises the problem of a down-regulation of the myeloid clone by the malignant lymphoid clone in this patient, and the possible mechanisms for this are discussed.
Bastion
Y
Y
Hematology Service, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France.
Thomas
X
X
Felman
P
P
Campos
L
L
Charrin
C
C
Coiffier
B
B
D001853:Bone Marrow / Q000473:pathology* / Q000648:ultrastructure; D002999:Clone Cells / Q000648:ultrastructure; D003114:Colony-Forming Units Assay; D015536:Down-Regulation; D006801:Humans; D007621:Karyotyping; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications* / Q000473:pathology; D008214:Lymphocytes / Q000473:pathology / Q000648:ultrastructure; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000150:complications* / Q000473:pathology