[Coincidence of chronic idiopathic myelofibrosis and chronic lymphocytic leukaemia. A rare phenomenon?].
In 1986 we diagnosed chronic idiopathic myelofibrosis (CIMF) in a 45-year-old asymptomatic patient with hepatosplenomegaly. In 1996 splenectomy was performed because of hypersplenism, and chemotherapy with hydroxyurea was initiated. In 1999 generalised lymphadenopathy of chronic lymphocytic leukaemia (B-CLL) developed. A trephine biopsy showed leukaemic bone marrow infiltration. On heteroduplex analysis we found a clonal rearrangement of IgH in the leukaemic lymphocytes. The coincidence of chronic myeloproliferative and lymphoproliferative diseases in the same patient is a rare phenomenon. According to the relevant literature, seven cases with a combination of CIMF/CLL have been reported. Possible pathomechanisms for the development of such coincidences are: 1) a bilineage manifestation of a pluripotent stem cell proliferation, 2) independent proliferations of two distinct cell lines under a common leukaemogenic stimulus or 3) an accidental association. These coincidence cases often showed a mild clinical course and also in our case, the patient is still alive and in a stable disease condition 16 years after the initial diagnosis.
Böhm
J
J
Pathologisches Institut, "Ludwig-Aschoff-Haus", Albert-Ludwigs-Universität Freiburg, Postfach 214, 79002 Freiburg, Germany. jboehm@ukl.uni-freiburg.de
Schaefer
H E
HE
Fisch
P
P
D003937:Diagnosis, Differential; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D055728:Primary Myelofibrosis / Q000150:complications* / Q000473:pathology*