Valvano Luciana, D'Auria Fiorella, Grieco Vitina, Statuto Teodora, Nozza Filomena, Pietrantuono Giuseppe, Villani Oreste, D'Arena Giovanni, Lamorte Daniela
Laboratory of Clinical and Advanced Diagnostics, Centro di Riferimento Oncologico della Basilicata (IRCCS CROB), Rionero in Vulture, Italy.
Laboratory of Clinical Pathology, Centro di Riferimento Oncologico della Basilicata (IRCCS CROB), Rionero in Vulture, Italy.
Front Oncol. 2022 Dec 5;12:1069977. doi: 10.3389/fonc.2022.1069977. eCollection 2022.
A case of concomitant hairy cell leukemia (HCL) and chronic lymphocytic leukemia (CLL) in a 50- year-old man was reported. Flow cytometry and droplet digital PCR (ddPCR) were used to detect the B-Raf proto-oncogene (BRAF) V600E mutation. The HCL population was the predominant component. The patient was first treated with cladribine and then with rituximab and achieved HCL partial remission. Importantly, the high sensitivity of our flow cytometric approach allowed the detection of a small population "P3," in addition to the typical HCL and CLL clones. The P3 clone changed over time, from an HCL-like to a CLL-like immunophenotype. This case is added to the few other cases of synchronous HCL and CLL already reported in the literature and underlines the importance of analyzing chronic lymphoproliferative disorders by highly sensitive diagnostic techniques, like the multicolor flow cytometry and ddPCR, to evaluate the possible association between HCL and CLL at diagnosis.
报告了一例50岁男性同时患有毛细胞白血病（HCL）和慢性淋巴细胞白血病（CLL）的病例。采用流式细胞术和液滴数字PCR（ddPCR）检测B-Raf原癌基因（BRAF）V600E突变。HCL群体是主要成分。该患者首先接受克拉屈滨治疗，然后接受利妥昔单抗治疗，实现了HCL部分缓解。重要的是，我们的流式细胞术方法具有高灵敏度，除了典型的HCL和CLL克隆外，还能检测到一小部分“P3”群体。P3克隆随时间变化，从HCL样免疫表型转变为CLL样免疫表型。该病例被添加到文献中已报道的其他少数同步HCL和CLL病例中，并强调了通过高灵敏度诊断技术（如多色流式细胞术和ddPCR）分析慢性淋巴细胞增殖性疾病的重要性，以评估诊断时HCL和CLL之间的可能关联。
