-

-, but coincident CLL at the same time of AML diagnosis. No prior therapy for CLL

-

56 yrs

M

-

-

-

no symptoms (no LP done)

52.2

10.2

158.0

86 (peripheral blood)

Bone Marrow Differential : Cellularity : o.k.- Megakaryocytes : present - Blasts : 66% "blast like" immature forms - Promyelocytes : 1% - Myeloid Activity : 13% - Erythroid Activity : 6% - Lymphocytes : 13% - Other : -

M0

A population of immature cells positive for CD45(dim), HLA-DR, CD7, CD34 (majority) and myeloid markers CD33 and CD13, with absence of staining for B cell, monocytic, and other T cell markers, consistent with myeloblast. A minor clonal kappa positive (moderate intensity) population of CD5 positive B cells which were negative for CD23 was also detected, suggesting a co-existing CD5 positive B cell lymphoproliferative disorder. A minor population of CD19 positive B cells co-expresses CD5 and exhibits monotypic surface immunoglobulin kappa light chain staining, consistent with involvement by the patient s known B cell lymphoproliferative disorder.

n/a

Cellular aspirate with prominent population of "blast-like" large cells with dispersed chromatin, distinct nucleoli and modest amounts of blue, agranular cytoplasm.

n/a

Acute Myelogenous Leukemia and Chronic Lymphocytic Leukemia

01-2002

Induction: ADE consisting of daunorubicin, cytarabine and etoposide plus PSC-833 (he was randomized to the treatment arm) on CALGB 19808. Consolidation with high-dose cytarabine and etoposide with stem cell harvest as per CALGB 19808.Auto stem cell transplant: on April 24, 2002. Conditioning regimen consisted of busulfan and etoposide as per CALGB 19808.

+ on BM on Feb 8, 2002

-

+ June 17, 2003

AML M0

D

06-2003

21

Bone Marrow

24

GTG

46,XY,t(4;12)(q11-12;p13)[18]/46,XY[2]

46,XY,t(4;12)(q11-q2;p13),+16,-17[1]/46,XY[19]

FISH with LSI (TEL/AML1 ES Dual Color Translocation Probe (Vysis, Inc.)) on metaphases

ish der(4)(dimTEL+), der(12)(dimTEL+)

The findings are consistent with AML. Although histologic features of chronic lymphocytic leukemia (CLL) are not seen, flow cytometric analysis shows a small subset of monoclonal B cells, consistent with persistent involvement by the patient s known CLL.