Development of acute myeloid leukemia in patients with untreated chronic lymphocytic leukemia

Abstract

The development of acute myeloid leukemia (AML) in patients with untreated chronic lymphocytic leukemia (CLL) is rare. We experienced a 65-year-old man who developed AML with aberrant CD7 expression and monoallelic CEBPA mutation during watchful waiting for CLL. He failed to achieve complete response (CR) by standard induction therapy for AML. We retrospectively reviewed 27 patients who developed AML with untreated CLL published between 1973 and 2016. The median age at diagnosis of AML was 68 years, and the median duration between the diagnoses of AML and CLL was 4.2 years. Diagnosis of AML and CLL was made simultaneously in 16 patients. The CR rate of AML was 42.9%, and the median survival was only 1.5 months after the diagnosis of AML. Patients who achieved CR tended to survive longer than those who did not. Our results demonstrated that the development of AML in patients with untreated CLL was associated with a poor response to chemotherapy and an extremely poor prognosis.

Acute Lymphocytic Leukemia With KMT2A-ELL Fusion Mutation in a Patient With Untreated Chronic Lymphocytic Leukemia: A Case Report and Literature Review

“…However, only tens of CLL concurrent with other hematologic malignancies have been described since 1970s (5)(6)(7). Currently, the development of subsequent multiple myeloma in patients with untreated CLL is generally diagnosed as therapy-related, and the prognosis of those patients is always inferior to that of de novo cases (8). Thus, the comprehensive reveal of diagnosis and clinical features of CLL patients concurrent with other hematologic malignancies is critical for the improvement of their survival rate.…”

Association of Chronic Lymphocytic Leukemia and Acute Myeloid Leukemia in Three Patients: Cases with the Concomitant Presence of Two Different Malignant Clones

“…AML is about 10 to 50 times more frequent in CLL patients than in the agematched general population. In one report, eleven patients developed AML during the course of untreated CLL, whereas AML and CLL were diagnosed concomitantly in 16 patients [10]. The concomitant occurrence of AML and CLL might stem from a common stem cell defect, leukomogenic factors or from a genetic predisposition in some patients.…”

Myelodysplastic Syndrome in a Patient With Untreated Chronic Lymphoproliferative Neoplasm

“…7,8,12 Opisuju se i rijetki slučajevi pojave AML-a u bolesnika s KLL-om. [13][14][15][16] Nekoliko je hipoteza o istodobnoj pojavi KLL-a i AML-a ili MDS-a. Neki smatraju da je moguća slučajna pojava dviju bolesti koje se relativno često javljaju u starijoj dobi.…”