Chen RR, Zhu LX, Wang LL, Li XY, Sun JN, Xie MX, Zhu JJ, Zhou D, Li JH, Huang X, Xie WZ, Ye XJ. Synchronous diagnosis and treatment of acute myeloid leukemia and chronic lymphocytic leukemia: Two case reports. World J Clin Cases 2021; 9(30): 9144-9150 [PMID: 34786398 DOI: 10.12998/wjcc.v9.i30.9144]
Corresponding Author of This Article
Xiu-Jin Ye, PhD, Chief Doctor, Department of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. yxjsunny@zju.edu.cn
Research Domain of This Article
Hematology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Rong-Rong Chen, Li-Xia Zhu, Lu-Lu Wang, Xue-Ying Li, Jia-Nai Sun, Mi-Xue Xie, Jing-Jing Zhu, De Zhou, Jian-Hu Li, Xin Huang, Wan-Zhuo Xie, Xiu-Jin Ye, Department of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Author contributions: Chen RR collected the patient’s clinical data, reviewed the literature, and drafted the manuscript; Zhu LX was the patients’ physician; Wang LL were involved in case analysis and treatment discussion; Ye XJ contributed to the drafting and revision of the manuscript; all authors issued final approval of the version to be submitted.
Informed consent statement: Consent was obtained from relatives of the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiu-Jin Ye, PhD, Chief Doctor, Department of Hematology, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, China. yxjsunny@zju.edu.cn
Received: March 28, 2021 Peer-review started: March 28, 2021 First decision: July 8, 2021 Revised: July 13, 2021 Accepted: September 3, 2021 Article in press: September 3, 2021 Published online: October 26, 2021
Abstract
BACKGROUND
The concurrence of acute myeloid leukemia (AML) and chronic lymphocytic leukemia (CLL) is rare. Previous reports of such cases have focused mainly on clinical diagnosis and characteristics, so the mechanism remains unclear, and therapy options have been poorly explored.
CASE SUMMARY
Here, we report two cases of synchronous AML and CLL. Flow cytometry revealed two distinct abnormal cell populations (myeloblasts and lymphoid cells) according to scatter characteristics. CD5-positive B cell lymphoma with myeloid leukemia invasion was observed on lymph node biopsy. Chemotherapy regimens indicated for both AML and CLL were used in our patients, and our patients achieved complete response after chemotherapy. Next-generation sequencing of 88 genes was performed.
CONCLUSION
We conclude that early mutation and dysregulation at the hematopoietic stem cell stage and the accumulation of multiple rearrangements may cause the concurrence of CLL and AML. The treatment of infection and combination therapy aimed at the CLL component are significant in the management of patients with concurrent CLL and AML.
Core Tip: The concurrence of acute myeloid leukemia (AML) and chronic lymphocytic leukemia is rare, and patients with both diseases have a poor prognosis. The clinical features, include male predominance and a predilection for older patients, and the AML-M2 subtype is the most frequent subtype. Infection and rapid progression are the most common causes of death in these patients.
