Published online Oct 26, 2021. doi: 10.12998/wjcc.v9.i30.9144
Peer-review started: March 28, 2021
First decision: July 8, 2021
Revised: July 13, 2021
Accepted: September 3, 2021
Article in press: September 3, 2021
Published online: October 26, 2021
Processing time: 206 Days and 22.2 Hours
The concurrence of acute myeloid leukemia (AML) and chronic lymphocytic leukemia (CLL) is rare. Previous reports of such cases have focused mainly on clinical diagnosis and characteristics, so the mechanism remains unclear, and therapy options have been poorly explored.
Here, we report two cases of synchronous AML and CLL. Flow cytometry revealed two distinct abnormal cell populations (myeloblasts and lymphoid cells) according to scatter characteristics. CD5-positive B cell lymphoma with myeloid leukemia invasion was observed on lymph node biopsy. Chemotherapy regimens indicated for both AML and CLL were used in our patients, and our patients achieved complete response after chemotherapy. Next-generation sequencing of 88 genes was performed.
We conclude that early mutation and dysregulation at the hematopoietic stem cell stage and the accumulation of multiple rearrangements may cause the concurrence of CLL and AML. The treatment of infection and combination therapy aimed at the CLL component are significant in the management of patients with concurrent CLL and AML.
Core Tip: The concurrence of acute myeloid leukemia (AML) and chronic lymphocytic leukemia is rare, and patients with both diseases have a poor prognosis. The clinical features, include male predominance and a predilection for older patients, and the AML-M2 subtype is the most frequent subtype. Infection and rapid progression are the most common causes of death in these patients.