Case Report of International Journal of Case Reports
Chronic Lymphocytic Leukemia, a Case Report
Faculty of Medicine,Titu Maiorescu University, Bucharest, Romania
Purpose of the presentation. The case presentation has as aim to describe the onset and evolution of a case of Chronic Lymphocytic Leukemia, (CLL), less common, which does not fit into the standard treatment criteria for malignant hemopathies.
Case description. The patient TA, female, 39 years of age, married, with 2 children, was admitted to the Emergency County Hospital of Targu Jiu in 2014, in the Internal Medicine Department for the Obstructive Chronic Bronchopathy with frequent coughing, night sweats, retrosternal pain. Clinical and ultrasound examination revealed splenomegaly, with spleen enlargement of 3 cm above normal diameters. The patient was also in the Endocrinology department with the diagnosis of Type II Diabetes and Grade III Obesity.
Laboratory results. Hemogram in 3 Diff revealed Hb = 14g / dL, Ht = 45%, Nr. Platelets of 275,000 / mm cub, but an increased number of Leucocytes, 117,000 / mm cub, and in the leucocyte formula from peripheral blood, the lymphocyte count was 80%, the absolute value being 9360. All biochemistry assays were in normal values, inclusive LDH = 375 md / dL, (N = 200-400 mg / d L. In the cytological examination of the peripheral blood smear stained with My Grunwald-Giemsa staining in the LPF 100 microscopy, was described the lymphocytosis with very small lymphocytes in high percent.
Conclusions; CLL onset occurs in a young female patient, contrary to the frequency of LLC in people over 65 years of age, especially in men. The normal baseline Hb, Ht%, Platelet counts in establishing the CLL diagnosis directly in stage I / II could be falsely positive due to the patient’s comorbidities with COPD and DZ type II and Obesity. Also low platelet counts in the final stage III / IV may be appropriate for the LLC disease stage or may be low due to applied chemotherapy.
Keywords: Chronic lymphocytic leukemia, p-53 protein, monoclonal antibodies from the CD receptor panel, CD38 receptor.
How to cite this article:
Aurelian Udristioiu Chronic Lymphocytic Leukemia, a Case Report. International Journal of Case Reports, 2018 3:36. DOI:10.28933/ijcr-2018-10-0401
1. Zenz T, Mertens D, Küppers R, Döhner et al. From pathogenesis to treatment of chronic lymphocytic leukaemia. Nat Rev Cancer. 2010 ; 10(1): 37-5.
2. Udristioiu A, Florescu C, Popescu MA, Cojocaru M. High Concentration of anaerobic ATP implicated in aborted apoptosis from CLL. LabMed 2010; 41: 203-08.
3. Hallek M. Chronic lymphocytic leukemia: 2015 Update on diagnosis, risk stratification, and treatment. Cancer Cell. 2010;17(1):28-40.
4. Gonzalez DK, Buzin HC, Dongqin Gu et.al. Beyond Li Fraumeni Syndrome: Clinical Characteristics of Families With p53 Germline Mutations. JCO 2009; 29 (8): 1250-6.
5. Read AP, Strachan T. Human molecular genetics 2. New York: Wiley, ISBN 0-471-33061-2, Chapter 18: Cancer Genetics 2009.
6. Udriștioiu A, Florescu C, Popescu AM, Cojocaru M. High concentration of anaerobic ATP implicated in aborted apoptosis from CLL, Lab. Med. 41; 2010: 203–8.
7. A. Coughlan, Gene therapy cures leukemia in eight days, New Sci.2013; 217; 2910: 29.
8. T. Zenz, D. Vollmer, M. Trbusek et al., “TP53 mutation profile in chronic lymphocytic leukemia: evidence for a disease spe- cific profile from a comprehensive analysis of 268 mutations,” Leukemia 2010; 24)12: 2072–2079.
9. D. Gonzalez, P. Martinez, R. Wade et al., “Mutational status of the TP53 gene as a predictor of response and survival in patients with chronic lymphocytic leukemia: results from the LRF CLL4 trial,” Journal of Clinical Oncology2011 (29)16: 2223–2229.
10. Asslaber D, Seyfried I et al., “microRNA-34a expression correlates with MDM2 SNP309 polymorphism and treatment-free survival in chronic lymphocytic leukemia,” Blood 2010;(115).21: 4191–4197.
11 Asslaber D, Pinon DJ, Seyfried I et al. “microRNA-34a expression correlates with MDM2 SNP309 polymorphism and treatment-free survival in chronic lymphocytic leukemia 2010; Blood; 115: 4191–7.
12. Rassent ZL, Jain Keatingetal JM.,“Relative value of ZAP70, CD38, and immunoglobulin mutation status in predicting aggressive in chronic lymphocytic leukemia. Blood 2008; 112: 1923–1930.
13. Krober A, Bloehdorn J, Hafner S, et al. Additional genetic high-risk features such as 11q deletion, 17p deletion, and V321 usage characterize discordance of ZAP-70 and V Hmutation status in chronic lymphocytic leukemia. Journal of Clinical Oncology 2006; 2: 969–75.
14. Shahjahani M, Mohammadias J, Noroozi F, Seghatoleslam M, Shahrabi S, Saba F, et al. Molecular basis of chronic lymphocytic leukemia diagnosis and prognosis. Cellular Oncology 2015; (38)2: 93–109.
15. Levy JM, Thompson JC, Griesinger AM, Amani V, Donson AM, Birks DK, et al. Autophagy inhibition improves chemosensitivity in BRAF(V600E) brain tumors. Cancer Discov 2014; 4(7):773–80.
16.Tasdemir E, Maiuri CM, Galluzzi L, Vitale J, Djavaheri-Mergny M, et al. Regulation of autophagy by cytoplasmic p53. Nat. Cell Biol 2008; 10: 676-87.
17. Tasdemir E, Maiuri CM, Galluzzi L, Vitale J, Djavaheri-Mergny M, et al. Regulation of autophagy by cytoplasmic p53. Nat. Cell
This work and its PDF file(s) are licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.