RRML - Atypical case of B-cell Chronic Lymphocytic Leukemia presenting with extreme hyperleukocytosis

Main page
News
RJLabM Credits
Archive
- Current issue
- Ahead of print
- List of published issues
- 2024
  - Nr.4/2024
  - Nr.3/2024
  - Nr.2/2024
  - Nr.1/2024
  - Supplement 1/2024
- 2023
  - Nr.4/2023
  - Nr.3/2023
  - Nr.2/2023
  - Nr.1/2023
  - Supplement 1/2023
- 2022
  - Nr.4/2022
  - Nr.3/2022
  - Nr.2/2022
  - Nr.1/2022
  - Supplement 1/2022
- 2021
  - Nr.4/2021
  - Nr.3/2021
  - Nr.2/2021
  - Nr.1/2021
- 2020
  - Nr.4/2020
  - Nr.3/2020
  - Nr.2/2020
  - Nr.1/2020
  - Supplement 1/2020
- 2019
  - Nr.4/2019
  - Nr.3/2019
  - Nr.2/2019
  - Nr.1/2019
  - Supplement 1/2019
- 2018
  - Nr.4/2018
  - Nr.3/2018
  - Nr.2/2018
  - Nr.1/2018
  - Supplement 1/2018
  - Supplement 2/2018
  - Supplement 3/2018
- 2017
  - Nr.4/2017
  - Nr.3/2017
  - Nr.2/2017
  - Nr.1/2017
  - Supplement 1/2017
- 2016
  - Nr.4/2016
  - Nr.3/2016
  - Nr.2/2016
  - Nr.1/2016
  - Supplement 1/2016
- 2015
  - Nr.4/2015
  - Nr.3/2015
  - Nr.2/2015
  - Nr.1/2015
  - Supplement 1/2015
- 2014
  - Nr.4/2014
  - Nr.3/2014
  - Nr.2/2014
  - Nr.1/2014
  - Supplement 1/2014
- 2013
  - Nr.4/2013
  - Nr.3/2013
  - Nr.2/2013
  - Nr.1/2013
  - Supplement 1/2013
- 2012
  - Nr.4/2012
  - Nr.3/2012
  - Nr.2/2012
  - Nr.1/2012
  - Supplement 1/2012
- 2011
  - Nr.4/2011
  - Nr.3/2011
  - Nr.2/2011
  - Nr.1/2011
  - Supplement 1/2011
- 2010
  - Nr.4/2010
  - Nr.3/2010
  - Nr.2/2010
  - Nr.1/2010
  - Supplement 1/2010
- 2009
  - Nr.4/2009
  - Nr.3/2009
  - Nr.2/2009
  - Nr.1/2009
  - Supplement 1/2009
- 2008
  - Nr.4/2008
  - Nr.3/2008
  - Nr.2/2008
  - Nr.1/2008
  - Supplement 1/2008
- 2007
  - Nr.4/2007
  - Nr.3/2007
  - Nr.2/2007
  - Nr.1/2007
- 2006
  - Nr.4/2006
  - Nr.3/2006
  - Nr.2/2006
  - Nr.1/2006
- 2005
  - Nr.1/2005
Instructions for authors
Online applications
- Send an article
- Online payments
Editorial
About us
Links

ISSN online: 2284-5623

ISSN-L: 1841-6624

Rejection rate (2020): 75%

Journal Metrics

Impact Factor 0.5
Five Year Impact Factor 0.5
JCI 0.12

Top 10 downloaded articles - November 2024 -

Towards appropriate training f...	31
Recomandările naționale ale ...	28
Biomarkers of acute kidney inj...	23
A comprehensive review of glyc...	20
Agreement between different eG...	19
Investigation of cytokine chan...	19
Expressions of vascular endoth...	17
Role of Th1/Th2 imbalance medi...	16
Small patients, big challenges...	9
The frequency of EGFR gene mut...	8

Concept, Design & Programming
Dr. Adrian Man

Nr. 22(4)/2014 DOI:10.2478/rrlm-2014-0043

Atypical case of B-cell Chronic Lymphocytic Leukemia presenting with extreme hyperleukocytosis

Anca Bacârea, Claudia Bănescu, Ioan Macarie, Judit Beáta Köpeczi, Bogdana Dorcioman

Abstract:

Very few cases of chronic lymphocytic leukemia (CLL) presenting with extreme hyperleukocytosis are reported in the literature. We describe the case of a 66 years old woman, with newly diagnosed CLL presenting with extreme hyperleukocytosis of 774.2 x 109/liter, Rai stage III and Binet stage C. The patient has no comorbidities and the CIRS score (cumulative illness rating scale) is well below 6, with normal creatinine clearance. Some other interesting aspects related with this case are the atypical immunophenotype, the expression of Cyclin D1, and the B hepatitis viral infection, which made her diagnosis and treatment challenging. The patient was tested for NOTCH1 mutation and it was positive. There is important evidence that NOTCH1 mutations are associated with rapidly progressive disease and resistance to treatment. The distinction of CLL from mantle cell lymphoma (MCL) is not always easy because some MCLs may mimic CLL clinically, histologically, and/or phenotypically. The hepatitis B prophylaxis for viral reactivation was not available an in the end the patient was treated only with fludarabine and cyclophosphamide, without rituximab. CD200 should be introduced in the routine panel for flow cytometry to distinguish CLL from mantle cell lymphoma and NOTCH1 mutation is associated with poor prognosis and should be evaluated at diagnosis. CLL with extreme hyperleukocytosis presentation is very rare and sometimes an atypical CLL may represent a diagnostic pitfall.

Keywords: CLL; extreme hyperleukocytosis; NOTCH1 mutation

Received: 26.8.2014
Accepted: 18.11.2014
Published: 1.12.2014

Download full text PDF
(1037 KB)

Bacârea A, Bănescu C, Macarie I, Köpeczi JB, Dorcioman B. Atypical case of B-cell Chronic Lymphocytic Leukemia presenting with extreme hyperleukocytosis. Rev Romana Med Lab. 2014;22(4):507-13. DOI:10.2478/rrlm-2014-0043