Blood Res.  2020 Sep;55(3):181-184. 10.5045/br.2020.2020079.

An illustrative case of B-cell prolymphocytic leukemia

• Jain A
• Khunger J
• Prasad P
• Chaudhry S
• Sharma M
• Gupta DK
• Saluja S

• KMID: 2507061
• DOI: http://doi.org/10.5045/br.2020.2020079

Abstract

No abstract available.

Figure

• 

  Fig. 1 Microphotograph of the bone marrow aspirate smear showing almost complete replacement by prolymphocytes (2–2.5 times the size of a mature lymphocyte with mild-moderate cytoplasm, open chromatin, and prominent nucleoli, Giemsa–Wright stain, ×100).

• 

  Fig. 2 Flow cytometry plots of the patient showing immunophenotype of the B-lymphocytes (red color). B-lymphocytes were CD45+, CD5+, CD23+ (heterogeneous), CD200dim+, CD19+, CD20+ (bright), surface CD22+ (bright), surface CD79b+ (bright), CD38+, surface kappa+ (bright), and surface IgDdim+. CD10, FMC7, CD25, CD11c, CD123, CD103, surface lambda, IgG, and IgM were negative.

Reference

1. Swerdlow SH, Campo E, Harris NL, editors. 2017. WHO classification of tumours of haematopoietic and lymphoid tissues. Revised 4th ed. IARC Press;Lyon, France:

2. Dearden C. 2012; How I treat prolymphocytic leukemia. Blood. 120:538–51. DOI: 10.1182/blood-2012-01-380139. PMID: 22649104.

3. Matutes E, Owusu-Ankomah K, Morilla R, et al. 1994; The immunological profile of B-cell disorders and proposal of a scoring system for the diagnosis of CLL. Leukemia. 8:1640–5. PMID: 7523797.

4. Sandes AF, de Lourdes Chauffaille M, Oliveira CR, et al. 2014; CD200 has an important role in the differential diagnosis of mature B-cell neoplasms by multiparameter flow cytometry. Cytometry B Clin Cytom. 86:98–105. DOI: 10.1002/cytob.21128. PMID: 24243815.

5. Chapiro E, Pramil E, Diop M, et al. 2019; Genetic characterization of B-cell prolymphocytic leukemia: a prognostic model involving MYC and TP53. Blood. 134:1821–31. DOI: 10.1182/blood.2019001187. PMID: 31527074.

6. Kay NE, Hanson CA. 2019; B-cell prolymphocytic leukemia has 3 subsets. Blood. 134:1777–8. DOI: 10.1182/blood.2019003046. PMID: 31751477.

7. Springael C, Delrieu V, Wu KL, et al. 2016; BHS guidelines for the treatment of large granular lymphocyte and chronic prolymphocytic leukaemias. Belg J Hematol. 7:103–11.

8. Gordon MJ, Raess PW, Young K, Spurgeon SEF, Danilov AV. 2017; Ibrutinib is an effective treatment for B-cell prolymphocytic leukaemia. Br J Haematol. 179:501–3. DOI: 10.1111/bjh.14224. PMID: 27391978.

9. Eyre TA, Fox CP, Boden A, et al. 2019; Idelalisib-rituximab induces durable remissions in TP53 disrupted B-PLL but results in significant toxicity: updated results of the UK-wide compassionate use programme. Br J Haematol. 184:667–71. DOI: 10.1111/bjh.15151. PMID: 29468637.

10. Wang HY, Zu Y. 2017; Diagnostic algorithm of common mature B-cell lymphomas by immunohistochemistry. Arch Pathol Lab Med. 141:1236–46. DOI: 10.5858/arpa.2016-0521-RA. PMID: 28608720.

11. Coelho H, Badior M, Melo T. 2017; Sequential kinase inhibition (Idelalisib/Ibrutinib) induces clinical remission in B-cell prolymphocytic leukemia harboring a 17p deletion. Case Rep Hematol. 2017:8563218. DOI: 10.1155/2017/8563218. PMID: 28819574. PMCID: PMC5551464.

12. Bindra BS, Kaur H, Portillo S, Emiloju O, Garcia de de Jesus K. 2019; B-cell prolymphocytic leukemia: case report and challenges on a diagnostic and therapeutic forefront. Cureus. 11:e5629. DOI: 10.7759/cureus.5629. PMID: 31700732. PMCID: PMC6822919.

13. Hew J, Pham D, Matthews Hew T, Minocha V. 2018; A novel treatment with obinutuzumab-chlorambucil in a patient with B-cell prolymphocytic leukemia: a case report and review of the literature. J Investig Med High Impact Case Rep. 6:2324709618788674. DOI: 10.1177/2324709618788674. PMID: 30038912. PMCID: PMC6050796.