Tekin GÜNEY, Şule Mine BAKANAY, Sema AKINCI, Abdulkadir BAŞTÜRK, Tuba HACIBEKİROGLU, İmdat DİLEK

An asymptomatic chronic lymphocytic leukemia case presenting at a very young age

Kronik lenfositik lösemi (KLL) ileri yaş hastalığı olup ortalama tanı yaşı 65 yaş ve üzeridir. Bu yazıda çok genç yaşta KLL tanısı konulan asemptomatik bir olgunun sunulması amaçlanmıştır. 24 yaşında herhangi bir yakınması olmayan erkek hastanın, yapılan rutin kan tetkiklerinde lökosit sayımı 46 x 109/l olarak bulundu.Periferik kan yayması olgun görünümlü lenfositlerden oluşan lenfositoz ile uyumluydu. Hastaya flowsitometrik inceleme ve kemik iliği biyopsisi yapıldı. Bu bulgular ve patolojik inceleme bulguları doğrultusunda KLL tanısı konuldu. Bu olgu bizim bilgilerimize göre literatürdeki üçüncü en genç KLL olgusudur. Diğer iki olgu kötü prognoz ile karakterli iken, bizim olgumuz herhangi bir kötü prognostik özelliğe sahip değildi. Sonuç olarak, sıklığı az olmasına rağmen lenfositoz ile takip edilen genç hastalarda KLL akılda bulundurulması gereken bir hastalıktır.

Çok genç yaşta kronik lenfositik lösemi tanısı konulan asemptomatik bir olgunun sunulması

Chronic lymphocytic leukemia (CLL) is a disease of advanced age with meanage ≥ 65 at diagnosis. In this paper, we aim to present an asymptomatic chronic lymphocytic leukemia case detected at very young age. A 24-year-old otherwise healthy male patient was found to have high white blood cell (WBC) count 46 x 109/l on routine blood tests. Peripheral blood smear was consistent with lymphocytosis with mature looking lymphocytes. A bone marrow biopsy and the flowcytometric immunophenotyping were performed. These findings and the pathological examination were consistent with CLL. To the best of our knowledge, our patient is the third young CLL case in the literature. This patient was diagnosed at an early stage of the disease and was asymptomatic. While the previously reported cases had poor prognosis, our patient did not possess any poor prognostic feature. As a result, although very infrequent, CLL can be diagnosed among young patients with lymphocytosis and should be kept in mind when treating these patients.

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1.Mims MP. Lymphocytosis, lymphocytopenia,hypergammaglobulinemia, and hypogammaglobulinemia. In: Hoffman R, Benz Jr. EJ, Silberstein LE, Heslop H, Weitz J, Anastasi J, editors.Hematology. Basic principles and practise.6. Edition, 2013. p.647-654.
2.Lin TS, Awan FT, Byrd JC. Chronic Lymphocytic Leukemia. In:Hoffman R, Benz Jr. EJ, Silberstein LE, Heslop H, Weitz J, Anastasi J, editors. Hematology. Basic principles and practise. 6. Edition, 2013. p. 1170- 1191.
3.Mauro FR, Foa R, Giannarelli D, Cordone I, Crescenzi S, Pescarmona E, et al. Clinical characteristics and outcome of young chronic lymphocytic leukemia patients: a single institution study of 204 cases. Blood. 1999; 94:44854.
4.Gribben JG, Zahrieh D, Stephans K, Bartlett-Pandite L, Alyea EP, Fisher DC, et al. Autologous and allogeneic stem cell transplantations for poor-risk chronic lymphocytic leukemia. Blood. 2005;106:438996.
5.Miguel CE, de Oliveira FM, Leite-Cueva SD, Rego EM, Falcão RP. A 23- year-old woman with 11q-chronic lymphocytic leukemia. Med Oncol. 2011; 28(4):1534-6.
6.Moreno C, Montserrat E. New prognostic markers in chronic lymphocytic leukemia. Blood Reviews 2008; 22(4):211-219.
7.Rosenquist R, Cortese D, Bhoi S, Mansouri L, Gunnarsson R. Prognostic markers and their clinical applicability in chronic lymphocytic leukemia: where do we stand? Leukemia&Lymphoma, 2013; 54(11):2351-64.
8.Villamor N, Conde L, Martínez-Trillos A, Cazorla M, Navarro A, Beà S, et al. NOTCH1 mutations identify a genetic subgroup of chronic lymphocytic leukemia patients with high risk of transformation and poor outcome. Leukemia 2013; 27 (5):1100-6.