Immune Pancytopenia Associated with a Leukemic B-Cell Tumor Carrying t(14;18)(q32;q21) Translocation

Abstract

We report a 75-year-old man who was initially suggested to have acute leukemia. The hemoglobin level was 3.8 g/dL, white cell count was 7,700/μL with an absence of mature neutrophils and 69.0% leukemic cells, and platelet was 0. The bone marrow consisted of normal hematopoietic precursors, whereas fluorescence in situ hybridization detected the BCL2/IgH fusion gene. He was treated with rituximab-containing chemotherapy, resulting in the resolution of pancytopenia. The underlying disease was a leukemic B-cell tumor with t(14;18)(q32;q21), and the pancytopenia was mainly caused by autoimmune mechanisms.