Blast crisis supervening on chronic lymphocytic leukaemia. A monoclonal progression of the disease as defined by cell surface markers

Abstract

Acute leukaemia is a rare event during the course of chronic lymphocytic leukaemia (CLL), and only a small fraction of such cases have been shown to be true acute lymphoblastic crises. 1 case is described where both small lymphocytes and proliferating lymphoblasts have the same monoclonal pattern as defined by direct immunofluorescence of membrane‐bound immunoglobulins. Previous cases are reviewed and do not appear to be mere coincidence: acute blast crisis may represent a part of the natural history of CLL.

B-Lymphoblastic Leukemia in Patients With Chronic Lymphocytic Leukemia

“…19 Subsequent to the review by Zarrabi et al, 4 only eight cases of B-LBL arising in patients with CLL have been reported ❚Table 3❚. 5,6,[10][11][12][20][21][22] Three patients had B-LBL diagnosed within 2 months of CLL diagnosis; this short time interval likely represents concurrent CLL and B-LBL at initial presentation. The other five patients developed B-LBL 8 months to 7 years after the diagnosis of CLL.…”