Refractory anaemia terminating in a combined lymphoproliferative and myeloproliferative disorder.
We report a case of non-sideroblastic refractory anaemia which evolved to a double lymphomyeloproliferative disorder. At presentation, bone marrow appearances and peripheral blood pancytopenia without myelomonocytosis were consistent with a diagnosis of non-sideroblastic refractory anaemia. Subsequently, the patient developed pronounced myelomonocytosis and lymphocytosis with prolymphocytes. Light and transmission electron microscopy as well as surface marker studies were compatible with a diagnosis of prolymphocytic transformation of chronic lymphocytic leukaemia/prolymphocytic leukaemia associated with myelomonocytic leukaemia. The pathogenesis of such double lympho-myeloproliferative disorders is discussed in the light of the evidence for common lymphoid and myeloid progenitor cells and some recent advances in the immunology of the myelodysplastic syndromes.
D000368:Aged; D000741:Anemia, Aplastic / Q000150:complications* / Q000473:pathology; D001773:Blood Cells; D001853:Bone Marrow / Q000473:pathology; D002452:Cell Count; D005260:Female; D006801:Humans; D007945:Leukemia, Lymphoid / Q000150:complications* / Q000473:pathology; D007951:Leukemia, Myeloid / Q000150:complications* / Q000473:pathology; D009378:Neoplasms, Multiple Primary / Q000473:pathology*