Acute lymphoblastic leukemia supervening in a case of chronic lymphocytic leukemia after continuous 3-year treatment with chlorambucil.
A case is presented of a patient with classical chronic lymphatic leukemia (CLL) treated with continuous chlorambucil for 3 years who presented with a picture of acute leukemia. The peripheral blood still showed a prevalence of mature lymphocytes with a few blast cells, whereas the bone marrow showed a predominant population of blast cells possessing a null acute lymphoblastic leukemia phenotype. Karyotype analysis showed a prevalent hyperdiploid clone of 67 to 68 chromosomes with endoreduplication and marker chromosomes. The coexistence of a CLL-type population with the blastic, undifferentiated cell clone suggests a second malignancy superimposed on the previous leukemic process, and possibly brought about by the continuous chlorambucil treatment.
D000368:Aged; D001853:Bone Marrow / Q000473:pathology / Q000648:ultrastructure; D002699:Chlorambucil / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007621:Karyotyping; D007945:Leukemia, Lymphoid / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D008297:Male
D002699:Chlorambucil