Acute myeloid leukemia in a chronic lymphocytic leukemia patient: diagnostic challenge (clinical case).

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Abstract

Chronic lymphocytic leukemia (CLL) and acute myeloid leukemia (AML) coexistence in the same patient has been rarely reported, more frequently due to treatment with chemotherapeutic agents. Blood parameter changes in cancer patients may be interpreted as disease progression or iatrogenic effects related to aggressive treatment, leading to delayed diagnosis. In our article, we call attention to the possibility of AML development in CLL patients and its diagnostic challenge.

About the authors

Marta Sofia Fernandes

Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos,EPE

Author for correspondence.
Email: martascf23@gmail.com
ORCID iD: 0000-0003-1900-1639

MD, Resident in Clinical Pathology

Portugal, Matosinhos, Portugal

Joana Martins

Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos,EPE

Email: JoanaMaria.Martins@ulsm.min-saude.pt

MD, Specialist in Clinical Hematology, Department of Clinical Hematology

Portugal, Matosinhos, Portugal

Maria Antónia Campos

Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, EPE

Email: antonia.campos@ulsm.min-saude.pt
ORCID iD: 0000-0001-8016-8660

MD, Consultant in Clinical Pathology, Department of Clinical Pathology

Portugal, Matosinhos, Portugal

Cacilda Magalhães

Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, EPE

Email: cacilda.magalhaes@ulsm.min-saude.pt
ORCID iD: 0000-0001-7407-4908

MD, Consultant in Clinical Pathology, Director of the Department of Clinical Pathology

Portugal, Matosinhos, Portugal

Yuliana O. Eremina

Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, EPE, Matosinhos; Institute of Public Health of the University of Porto

Email: yuliana.eremina@ulsm.min-saude.pt
ORCID iD: 0000-0002-3656-7266
ResearcherId: ABD-8614-2020

MD, PhD, Specialist in Clinical Pathology, Assistant of the Department of Clinical Pathology, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, EPE, Matosinhos; Collaborator of Environmental and Laboratorial Epidemiology Research Group (EPIUnit), Environmental Health Department

Portugal, Matosinhos, Portugal

References

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  3. Dong Q, Xiu Y, Bossler A, et al. CLL dedifferentiation to clonally related myeloid cells. Blood Advances. 2020;4(24):6169-74. doi: 10.1182/blood advances.2020002726
  4. Schoorl M, Schoorl M, Chevallier M, et al. Flagging performance of the Sysmex XN2000 haematology analyser. International Journal of Laboratory Hematology. 2016;38(2):160-6. doi:10.1111/ ijlh.12461
  5. Furundarena JR, Sainz M, Uranga A, et al. Comparison of abnormal cell flagging of the hematology analyzers Sysmex XN and Sysmex XE-5000 in oncohematologic patients. International Journal of Laboratory Hematology. 2017;39(1):58-67. doi:10. 1111/ijlh.12575
  6. Eilertsen H, Saether PC, Henriksson CE, et al. Evaluation of the detection of blasts by Sysmex hematology instruments, CellaVision DM96, and manual microscopy using flow cytometry as the confirmatory method. International Journal of Laboratory Hematology. 2019;41(3):338-44. doi: 10.1111/ijlh.12980

Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Sysmex 5000 – Scattergram cytoDIFF

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3. Fig. 2. PB Smear (May-Grunwald-Giemsa staining) microscopy (500×): A – Smudge cell, B – Blast cells, C – Lymphocytes

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Copyright (c) 2021 Fernandes M., Martins J., Campos M., Magalhães C., Eremina Y.O.


 


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