Clinical and clinicopathological characteristics of acute lymphoblastic leukaemia in six cats

Tomiyasu, Hirotaka; Doi, Akitaka; Chambers, James K.; Goto‐Koshino, Yuko; Ohmi, Aki; Ohno, Koichi; Tsujimoto, Hajime

doi:10.1111/jsap.12917

Cited by 15 publications

(9 citation statements)

References 5 publications

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“…As alterações mais importantes no presente caso foram a leucocitose (187.100/µL), linfocitose (185.229/µL), presença de 72% de linfoblastos no sangue, predomínio de 59% de linfoblastos na medula óssea e de 30% no líquido cefalorraquidiano, alterações presentes na LLA com infiltração de células neoplásicas no sistema nervoso central [3,5,10]. Observou--se anemia não regenerativa (hematócrito 22%) e trombocitopenia (66.000/µL), devido à infiltração de células leucêmicas na medula óssea [3].…”

Section: Discussionunclassified

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Central Nervous System Infiltration in Acute Lymphoblastic Leukemia in a Dog

Souza

Pinto

Oliveira

et al. 2021

Acta Scientiae. Vet.

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Background: Acute lymphoblastic leukemia (ALL) is a malignant neoplasia in which there is proliferation of lymphoid progenitor cells in the bone marrow, blood, and extramedullary sites. This disorder has a fast and progressive development; in dogs, cases of infiltration of ALL cells in the central nervous system (CNS) are uncommon and rare. Diagnosis can be achieved with the help of the clinical history and physical, radiographic, hematological, myelographic, and cerebrospinal fluid (CSF) tests in patients with or without neurological clinical signs. The present report aims to describe a case of ALL and the presence of lymphoblasts in the CSF of a dog with neurological clinical signs.Case: An 8-year-old Lhasa Apso dog was examined at the Veterinary Hospital of Universidade Federal do Paraná, Curitiba campus. At the physical examination, the animal exhibited apathy and paralysis of pelvic limbs, which progressed to tetraplegia. Abdominal palpation revealed presence of hepatosplenomegaly and absence of lymphadenomegaly. No alterations were observed in radiographs of the cervical, thoracic or lumbar spine. A complete blood count revealed presence of non-regenerative anemia (hematocrit = 22%), extreme lymphocytosis (185,229 cells/µL), lymphoblasts at a level of 72% (133,364 cells/µL), and thrombocytopenia (66,000 platelets/µL). The biochemical tests revealed increased alkaline phosphatase (859 IU/L). The levels of alanine aminotransferase, creatinine, urea, total protein, albumin, and globulin were normal. The diagnosis of ALL was achieved with the help of a myelogram. The myelogram findings included 39% of mature lymphocytes and 59% of lymphoblasts exhibiting large size, spherical shape, poorly delimited borders, with a high nucleus/cytoplasm ratio, marked cytoplasmic basophilia, and 2 to 3 evident nucleoli; metarubricytes (1%) and promyelocytes (0.6%) were also observed. The CSF contained an increased number of nucleated cells (27 cells/µL) comprising lymphocytes (43%), macrophages (33%), and segmented neutrophils (24%). Of the 11.6 lymphocytes per µL of CSF, 8.1 were lymphoblasts, which indicates infiltration of ALL cells in the CNS. The animal died one day after collection of bone barrow and CSF. Discussion: Relevant alterations observed in this case included the neurological signs caused by the infiltration of neoplastic cells in the CNS, severe leukocytosis and lymphocytosis, with large amounts of lymphoblasts in the blood and predominance of lymphoblasts in the bone marrow, which are alterations typically found in ALL. The animal also exhibited non-regenerative anemia and thrombocytopenia, which were secondary to infiltration of leukemic cells in the bone marrow. The CSF exhibited pleocytosis (27 cells/ µL), and 30% of the cells observed were lymphoblasts. Lymphoblast infiltration in the CNS of leukemic dogs is rare, and other studies have reported absence of neurological signs or neurological signs different from those observed in the present study. CSF analysis in indicated in cases of leukemia to assess leukemic cell infiltration in the CNS. In the case reported here, the plasma level of alkaline phosphatase was increased (859 IU/L) as a consequence of hepatomegaly and hepatic cholestasis. ALL is a very aggressive, proliferative neoplasia, and the resulting lymphoblasts infiltrated the CNS of the animal. In cases of ALL, performing complete blood count, myelogram, and CSF analysis is indicated whether the patients exhibit neurological signs or not.

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Section: Discussionunclassified

“…As leucemias agudas são invasivas e não responsivas ao tratamento, com prognóstico desfavorável [2,3,10]. Este relato objetivou descrever um caso de LLA em cão com sinais neurológicos decorrentes da infiltração de células neoplásicas no SNC, demonstrando a importância da análise citológica do líquido cefalorraquidiano nas leucemias.…”

Section: Introductionunclassified

Central Nervous System Infiltration in Acute Lymphoblastic Leukemia in a Dog

Souza

Pinto

Oliveira

et al. 2021

Acta Scientiae. Vet.

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“…Las formas agudas suelen ser más agresivas que las crónicas (Vail, 2016). La leucemia linfoblástica aguda se origina de precursores linfoides inmaduros, tiene una prognosis pobre y una proporción mayor al 50 % de linfoblastos en relación con las células nucleadas de la médula ósea (Tomiyasu et al, 2018). Este tipo de leucemia es común en gatos infectados con el ViLeF.…”

Section: Aspectos Clínicosunclassified

“…Dependiendo del tipo de linfoma, existirá una relación alta o baja con este retrovirus, y los signos clínicos estarán relacionados con el órgano afectado (MacLachlan & Dubovi, 2017;Paulin et al, 2018;Vail, 2017). Por otro lado, se han descrito procesos leucémicos de tipo linfoblásticos agudos para este virus (Tomiyasu et al, 2018;Vail, 2016).…”

Section: Introductionunclassified

Aspectos epidemiológicos, clínicos y de diagnóstico del ViLeF y VIF: una revisión actualizada

et al. 2019

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Los virus de la leucemia felina (ViLeF) e inmunodeficiencia felina (VIF) están clasificados dentro de la familia Retroviridae y son patógenos que afectan a los gatos domésticos. Estos retrovirus felinos tienen alta capacidad de mutación y recombinación, lo cual favorece una amplia población de subtipos virales con capacidades patogénicas diferentes. Tienen gran relevancia en la salud felina, no solo por la severidad de las manifestaciones clínicas en los pacientes, sino también por la complejidad diagnóstica que pueden representar. El rango de prevalencias es amplio entre distintos estudios y zonas geográficas, probablemente por influencia de los factores de riesgo, las condiciones clínicas de los gatos y las pruebas diagnósticas utilizadas. Las manifestaciones clínicas de la patogenia del ViLeF son variables, dependiendo del subtipo viral y del inmunocompromiso del hospedero, ya que pueden existir linfomas, leucemias, aplasia eritrocitaria, mielosupresión e inmunodeficiencia. Por otro lado, el VIF tiene un marcado tropismo hacia los linfocitos TCD4+, lo cual desencadena una inmunodeficiencia característica, pero también se ha descrito un frecuente neurotropismo. Para ambos virus, el diagnóstico de rutina es de tipo serológico, sin embargo, en algunas situaciones no es posible identificar correctamente a los gatos infectados. En estudios recientes se ha incluido el diagnóstico de estos virus por medio de la reacción en cadena de la polimerasa (PCR), lo que abre una posibilidad a la disminución de errores diagnósticos para el ViLeF, pero aún se discute su efectividad para la detección del VIF. El objetivo del presente artículo es proporcionar información actualizada y precisa sobre los aspectos epidemiológicos, clínicos y de diagnóstico del ViLeF y VIF en gatos domésticos

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“…The clinical course appeared relatively indolent with most cats treated with prednisone and chlorambucil. Six cases of acute lymphoblastic leukemia were described in cats, diagnosed based on the percentage of blasts and concurrent cytopenias, and found a short median survival (55 days) . Immunophenotyping by PARR, flow cytometry, immunohistochemistry, or some combination of these identified 4 cases as B‐cell lineage and 1 case as T‐cell lineage, and 1 case expressed B‐cell and T‐cell antigens.…”

Section: Introductionmentioning

confidence: 99%

Immunophenotypic characterization and clinical outcome in cats with lymphocytosis

Rout

Labadie

Curran

et al. 2019

Veterinary Internal Medicne

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Background: Lymphocytosis is relatively common in cats, but few studies describe lymphocyte populations or the clinical course associated with different immunophenotypic expansions.Hypothesis/Objectives: We hypothesized that cats frequently develop nonneoplastic lymphocytosis and that different neoplastic immunophenotypes have variable prognoses. We aimed to characterize the lymphocyte expansions in a large population of cats with lymphocytosis and to assess clinical presentation and outcome in a subset.Animals: Three cohorts of cats older than 1 year with lymphocytosis (>6000/μL) were examined to define immunophenotypic categories (n = 146), evaluate outcome (n = 94), and determine prevalence of immunophenotypes (n = 350).Methods: Retrospective study of cats with blood submitted for flow cytometry.Medical records (n = 94) were reviewed for clinical data, treatment, and survival information. Results: Five major immunophenotypic categories were identified: B cell, heterogeneous (≥2 lineages expanded), CD4+ T cell, CD4−CD8− (double negative [DN]) T cell, and CD5-low-expressing T cell. B-cell and heterogeneous phenotypes were more consistent with a non-neoplastic process, having polyclonal antigen receptor gene rearrangements, younger age at presentation, lower lymphocyte counts, and prolonged survival. The neoplastic phenotypes, CD4+ T cell, DN T cell, and CD5 low T cell, had different median survival times (752 days [n = 37], 271 days [n = 7], 27.5 days [n = 12], respectively). Among CD4+ T-cell cases, cats with abdominal lymphadenopathy, intestinal involvement, or both and females had shorter survival. Among 350 cats with lymphocytosis, CD4+ T-cell lymphocytosis was most common, followed by heterogeneous and B-cell phenotypes. Conclusions and Clinical Importance: Neoplastic CD4+ T-cell lymphocytosis is common in cats and has a prolonged clinical course compared to aberrant T-cell

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Clinical and clinicopathological characteristics of acute lymphoblastic leukaemia in six cats

Abstract: Acute lymphoblastic leukaemia should be considered if lymphoblasts are observed in peripheral blood, even if their number is small. The prognosis for cats that have acute lymphoblastic leukaemia is as poor as that for dogs, and further studies are needed to develop effective treatment.

Cited by 15 publications

References 5 publications

Central Nervous System Infiltration in Acute Lymphoblastic Leukemia in a Dog

Central Nervous System Infiltration in Acute Lymphoblastic Leukemia in a Dog

Aspectos epidemiológicos, clínicos y de diagnóstico del ViLeF y VIF: una revisión actualizada

Immunophenotypic characterization and clinical outcome in cats with lymphocytosis

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