1/14. Treatment of T-prolymphocytic leukemia with nonmyeloablative allogeneic stem cell transplantation.AIM: T-prolymphocytic leukemia (T-PLL) is a rare disease of the elderly characterized by a high white blood cell count and organomegaly, and is currently incurable. Our aim was to elicit graft-versus-leukemia reactions in a patient with T-PLL. methods: A 52-yr-old woman with refractory T-PLL underwent a nonmyeloablative regimen followed by allogeneic peripheral blood stem cell transplantation (a "minitransplant") from her HLA-matched sibling. RESULTS: There was no treatment related toxicity other than neutropenia. Engraftment was successful. The patient experienced no graft-versus-host disease (GVHD) at any time but, on day 84 after transplantation, had a relapse in the central nervous system. Despite infusion of donor lymphocytes and intralumbar chemotherapy, she died on day 157 of systemic disease. CONCLUSION: The reasons why treatment may have failed are discussed (nature of disease, disease progression, treatment schedule).- - - - - - - - - - ranking = 1keywords = white blood cell, white blood, blood cell, white (Clic here for more details about this article) |
2/14. Mantle cell leukemia, prolymphocytoid type: a rarely described form.Leukemic manifestations of mantle cell lymphoma are seen in a minority of cases, usually associated with extensive tumor. Usually the neoplastic cells in the peripheral blood resemble mantle cells with a mature chromatin pattern and irregular nuclear contours, or less frequently with a more "blastic" chromatin pattern. A prolymphocytic leukemia with t(11;14)(q13;q32) has previously been reported; however, a complete flow cytometric immunophenotypic profile was lacking. Mantle cell leukemia, prolymphocytoid type with complete flow cytometric data has not previously been described and is the purpose of this report. We report such a case in a 90 year-old female who presented with an elevated white blood cell count. The diagnosis was based on flow cytometric immunophenotyping and the cytomorphology of the peripheral blood combined with cyclin d1 immunohistochemical staining of the bone marrow. We describe our findings and her clinical course in order to heighten awareness of this previously rarely described entity.- - - - - - - - - - ranking = 1keywords = white blood cell, white blood, blood cell, white (Clic here for more details about this article) |
3/14. Prolymphocytic leukaemia and Hodgkin's lymphoma.We describe a case of B-prolymphocytic leukaemia (B-PLL) who, following a long-lasting remission with fluradabine, developed a Hodgkin's lymphoma (HL) with bone marrow involvement. A 75-yr-old male was found to have a lymphocytosis [white blood cell (WBC) count = 146 x 10(9) L(-1)], small volume axillary lymphadenopathy, and hepatosplenomegaly. The majority of circulating lymphocytes had a round nucleus and prominent single nucleolus. The patient did not respond to chlorambucil and then received fludarabine, achieving a good response lasting for 5 yr, when he manifested with B symptoms and pancytopenia. A diagnosis of HL in the bone marrow was made based on histology (reed-sternberg cells) and immunohistochemistry (CD30 , CD15 ). Epstein-Barr virus (EBV) studies were negative. The patient was treated with chemotherapy but died 6 months later from disease progression.- - - - - - - - - - ranking = 1keywords = white blood cell, white blood, blood cell, white (Clic here for more details about this article) |
4/14. Small cell variant of T-cell prolymphocytic leukemia with a gammadelta immunophenotype.T-cell prolymphocytic leukemia (T-PLL) is a rare postthymic T-cell disorder. The disease is characterized by lymphadenopathy, splenomegaly, skin lesions, a high white blood cell count, and an aggressive clinical course. The small cell variant of T-PLL occurs in approximately 20% of patients. Most T-PLL patients express membrane T-cell receptors (TCR) of the alphabeta phenotype. The diagnosis of small cell variant T-PLL in a 56-year-old woman was based on the findings of abnormal lymphocytosis, immunophenotype, lymphadenopathy, and aggressive clinical behavior. Immunophenotype analysis showed that lymphocytes were positive for CD2, CD3, CD5, CD7, CD8, and TCR gammadelta antigens and negative for CD1a, CD4, and TCR alphabeta antigens. Southern blot analysis revealed rearrangement of the TCR Jgamma and Jdelta-1 genes. A cytogenetic study of peripheral blood showed a normal karyotype. T-PLL with a TCR gammadelta phenotype is very rare. This case was typical T-PLL except for the morphologically small cell type and the lack of the typical chromosome aberration. If cases accumulate in the future, the specific features of the gamma8 type of T-PLL will become clearer.- - - - - - - - - - ranking = 1keywords = white blood cell, white blood, blood cell, white (Clic here for more details about this article) |
5/14. Burkitt-type acute leukemia in a patient with B-prolymphocytic leukemia: evidence for a common origin.Burkitt-type acute leukemia cells were present in the bone marrow of a patient with B-prolymphocytic leukemia diagnosed from peripheral blood cell morphology. Immunophenotype analysis confirmed morphological patterns. Cytogenetic and fluorescence in situ hybridization (FISH) analysis showed an identical t(8;22)(q24;q21) with MYC locus rearrangement in blood and bone marrow cells, with additional chromosome abnormalities in the bone marrow. In addition, the loss of one copy of the TP53 gene and identical IGH dna clonal rearrangements were shown with FISH and polymerase chain reaction analysis respectively in the two types of leukemic cells. These data indicated the common origin of the two coexisting leukemias and are the first example of such occurrence in a leukemic patient.- - - - - - - - - - ranking = 0.14893927851931keywords = blood cell (Clic here for more details about this article) |
6/14. An indolent case of T-prolymphocytic leukemia with t(3;22)(q21;q11.2) and elevated serum beta2-microglobulin.We report a novel case of T-prolymphocytic leukemia, small cell variant, associated with complex cytogenetic findings including t(3;22)(q21;11.2) and elevated serum beta2-microglobulin. The diagnosis is based on morphologic, immunophenotypic, cytogenetic, and molecular analysis of peripheral blood and bone marrow. In contrast to most reported cases of T-prolymphocytic leukemia, this patient did not present with lymphadenopathy or organomegaly. Moreover, only a moderate leukocytosis (25.3 x 10(3)/microL) was evident at presentation. In the absence of any specific treatment, the patient is doing well, with a stable white blood cell count 12 months following presentation. Further investigation may be warranted to determine whether the unusual cytogenetic findings and elevated serum beta2-microglobulin are associated with the indolent clinical course in this patient.- - - - - - - - - - ranking = 1keywords = white blood cell, white blood, blood cell, white (Clic here for more details about this article) |
7/14. Prolymphocytic leukemia treated with natural and recombinant alpha-interferon.The patient was a 65 year old woman with a massive splenomegaly and no lymphoadenopathy. An electron microscopic study of the peripheral blood cells revealed that these cells were prolymphocytes with a single large nucleolus. Treatment with native and recombinant alpha-interferon has produced an impressive reduction in spleen size and in the count of prolymphocytes.- - - - - - - - - - ranking = 0.14893927851931keywords = blood cell (Clic here for more details about this article) |
8/14. B-cell prolymphocytic leukemia expressing CD13 antigen.Although the expression of myeloid-associated antigen CD13 has been reported in aggressive B-cell chronic lymphocytic leukemia, its expression in other mature B-cell neoplasms appears to be rare. We report a 74-year-old female with B-cell prolymphocytic leukemia (B-PLL) expressing CD13 antigen. On admission, splenomegaly was noted. Hematological examination revealed a platelet count of 90 x 10(9)/l and a white cell count of 68 x 10(9)/l with 73% PLL cells. The hemoglobin concentration was 10.6 g/dl. A bone marrow aspirate showed a normocellular marrow with 64% PLL cells. Surface marker analysis of the PLL cells was positive for CD11b, CD13, CD19, CD20, CD24, HLA-DR, FMC7, mu and lambda. Simultaneous expression of CD13 and CD19 antigen was confirmed by dual color flow cytometry. Southern blot analysis of dna from circulating mononuclear cells gave a rearranged band for the immunoglobulin gene (JH) but not for TCR-beta. cytogenetic analysis of marrow cells showed an abnormal karyotype involving numbers 1, 7, 10, 12, 14, 15 chromosomes.- - - - - - - - - - ranking = 0.0050022123621733keywords = white (Clic here for more details about this article) |
9/14. Chronic prolymphocytoid leukaemia with an unusual immature immunophenotype.A case of a 58 year old woman with a chronic lymphoproliferative disorder of unusual clinical presentation, disease course, and immunophenotype is presented. At diagnosis she had severe anaemia, moderate lymphocytosis with some cells having prolymphocytoid features and a normal platelet count. A clinical examination yielded negative results. Only anaemia related symptoms were found and the patient became blood transfusion dependent. Both the lymphocytosis and the proportion of prolymphocytoid cells rose insidiously and thrombocytopenia developed later during the course of the disease. Three years later, the patient had a white cell count of 269 x 10(9)/l almost exclusively of prolymphocytoid cells and the bone marrow was diffusely infiltrated. She was refractory to chemotherapy and the anaemia did not improve after treatment with cyclosporine. Lymphoid cells were positive for cytoplasmatic CD3, HLA-Dr, CD34, CD38, CD7, CD56, CD13, CD33 and CD65. Membrane alpha beta and gamma delta T cell receptors (TCRs) were not expressed and the beta chain TCR gene was in germline configuration. Other membrane T, B, natural killer, and myelomonocytic markers were negative. Karyotype analysis was tried several times but metaphases were not obtained, even after stimulation with T cell mitogens.- - - - - - - - - - ranking = 0.0050022123621733keywords = white (Clic here for more details about this article) |
10/14. B-cell prolymphocytic leukemia expressing discordant myeloid-associated antigens in simultaneous specimens from bone marrow and peripheral blood.The case of a 73-year-old man with B-cell prolymphocytic leukemia (PLL) and rapid clinical demise is reported. Flow cytometric immunophenotyping results of specimens obtained from the patient demonstrated a monoclonal CD5 positive B-cell population with myeloid-associated marker expression, which was discordant: CD15 and CD11b were expressed in bone marrow leukemic cells, whereas peripheral blood leukemic cells showed virtually no expression of these markers. Discordant immunophenotyping results between bone marrow and peripheral blood cells have been reported recently. Additionally, investigators have associated expression of CD13 and CD11b by chronic B-cell lymphoid leukemias with a more aggressive clinical course and shorter survival. Expression of these myeloid-associated antigens by B-cell prolymphocytes in PLL has not been widely reported. cytogenetic analysis revealed a karyotype of 46,XY/?44,XYdel(1q),del (3p), whereas molecular genetic studies demonstrated immunoglobulin gene rearrangements in both heavy and light chain regions. Cytochemical staining for PAS (periodic acid-Schiff), nonspecific esterase and methyl-green-pyronin was positive in leukemic cells.- - - - - - - - - - ranking = 0.14893927851931keywords = blood cell (Clic here for more details about this article) |
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