Solid tumors after chronic lymphocytic leukemia patients: report of six cases and review of the literature

Introduction: Malignancies have been reported to occur with increased frequency in chronic lymphocytic Leukemia [CLL] patients. The aim of this study was to describe which second malignancies occur in patients with CLL, whether these malignancies are related to CLL, its treatment, or both. We also attempt to study factors predicting the development of other malignancies

Patients and methods: Between 1995 and 2009, six cases of CLL associated with solid tumor were diagnosed in Hematology Department of Military Hospital of Tunis. The diagnosis of CLL was made by immunophenotyping of peripheral blood circulating B cells, and the diagnosis of solid tumors was made by biopsy with anatomopathological exam and immunohistochemical study

Results: The mean age of patients was 71 years. Five patients were male. The CLL was classified Stage A in one case, Stage B in three cases and Stage C in two cases. Two patients had abnormal karyotype. Three patients have not received specific treatment for their CLL. Solid tumors were represented by skin cancer in three cases, lung cancer in two cases and breast cancer in one case. The median time between diagnosis of CLL and that of solid tumor was 53 months

Conclusion: Patients with CLL have an increased risk of developing a second cancer. Awareness of risk factors could permit early detection

[Contribution of RT-PCR for diagnosis of chronic myeloid leukemia]

The molecular analysis of chromosomal abnormalities associated with hematological malignancies allowed the identification of genes involved in theses rearrangements as well as of some recurrent mechanisms. Polymerase chain reaction [PCR] tools are now available to detect these rearrangements, allowing a better follow-up of these diseases. Chronic myeloid leukemia is a myeloproliferative disorder characterized by a reciprocal translocation t[9;22][q34;q11] which results in a bcr-abl fusion gene. Retro-transcription polymerase chain reaction [RT-PCR] is used to detect bcr-abl to establish diagnosis and to monitor patients. We report here the results of 30 patients samples tested in the hematology laboratory at Pasteur Institute, diagnosed as chronic myeloid leukemia and monitored with RT-PCR. Our results highlight the interest of molecular tools to diagnose and monitor patients mainly when cytogenetic techniques are irrelevant such as cases with complex chromosomal rearrangements or when patients achieve Philadelphia negativity after treatment

[Cytology and immunophenotyping of acute promyelocytic leukemia]

Acute promyelocytic leukaemia [AML3] is characterized by particular clinical and biological features. We report the cytology and the immunophenotype of 14 AML3 from which 3 were AML3v. A double negativity of HLA-DR and CD34 is found in 12 cases and aberrant expression of CD2 in 2 AML3v. Aberrant expression of CD56 and CD22 was shown in, respectively, one case, CD15, CD65 and CD117 expressions were variable. Cytological diagnosis is often evident, although in some cases, it is not typicaland immunophenotype will contribute to the diagnosis

Resultats therapeutiques des leucemies aigues lymphoblastiques de l'enfant en Tunisie [181 cas]

Average lifetime of childhood acute lymphoblastic leukemia [ALL] has increased considerably during the last decade. Most authors agree to report a recovery rate close to 50%. A retrospective study of 181 patients followed and treated in Tunisia, shows that we are, unfortunately, far from these recovery rates, given that we only obtain a 15% rate of longer than two years survival. Our bad therapeutic results are very probably related to the clinic, cytologic and immunologic profile, characteristic of the ALL. in Tunisia

Etude genetique de la thrombasthenie de Glanzman [a propos de 22 cas]

A genetic study conducted on 22 patients suffering from GLANZMANN thrombasthenia has shown a very high consanguinity percentage that reaches 77%, with a first degree consanguinity of 76%. This high thrombasthenia frequency found in children with consanguinuous parents, should lead [for good genetic advice] to case finding of heterozygotes. This case finding is possible today with the detection of "L" antibodies

Resultats therapeutiques des leucemies aigues lymphoblastiques de l'enfant en Tunisie [181 cas]

Average lifetime of childhood acute lymphoblastic leukemia [A.L.L.] has increased considerably during the last decade. Most authors agree to report a recovery rate close to 50%. A retrospective study of 181 patients followed and treated in Tunisia, shows that we are, unfortunately, far from these recovery rates, given that we only obtain a 15% rate of longer than two years survival. Our bad therapeutic results are very probably related to the clinic, cytologic and immunologic profile, characteristic of the A.L.L. in Tunisia. In fact, our series differs from other countries' series by the high percentage of those forms said right away of bad pronostic. For these very high risk forms, a heavy chemotherapy treatment, assisted by an effective hematologic reanimation, should increase the percentage of long survivals