Detection and monitoring of a concomitant atypical myeloproliferative disorder and chronic lymphocytic leukemia by flow-cytometric immunophenotyping.

OBJECTIVE

To illustrate the utility of a broad panel of monoclonal antibodies to detect secondary processes or unexpected characteristics of the primary blood dyscrasia.

DESIGN

Case report and discussion.

SETTING

Regional academic medical center.

PATIENT

A 64-year-old man presenting with an apparent acute myeloid leukemia.

INTERVENTIONS

Sequential immunophenotyping with a broad panel of monoclonal antibodies to monitor progression of disease and response to therapy.

MAIN OUTCOME MEASURE

Identification and monitoring of the two atypical populations in this patient with correlation to the clinical status of the patient.

RESULTS

Identification of an unsuspected mature lymphoid clone and characterization of the evolution of the myelomonocytic clone.

CONCLUSION

The evolving mature lymphoid clone may have been overlooked in the context of a predominant atypical myeloproliferative process, particularly if a limited panel of monoclonal antibodies had been used for immunophenotyping. Sequential immunophenotyping was useful in monitoring the progression of each atypical process.