A case of T cell CLL with marked increase of leukemic cells in final stage.

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  • 末期に急激な白血球増多を認めたＴ細胞性慢性リンパ性白血病の１例

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Abstract

74-year-old woman, who was a native of Saitama prefecture, was admitted to our hospital because of discomfort in epigastrium in May 1982. Physical examination on admission revealed no lymphadenopathy, hepatosplenomegaly and skin lesions. RBC was 385×104 per cmm, Hb 11.9 g per dl and Ht 36.4%. WBC was 39,400 per cmm with 92.5% lymphoid cells. Platelet was 20.5×104 per cmm. Bone marrow showed 70% lymphoid cells. Lymphoid cells had not convoluted nuclei typical in ATL and responded normally to PHA and Con A. Immunological examination showed 98% sheep ERFC, 99% OKT 3+, 97% OKT 4+, positive C3d receptor, negative TdT, negative anti-ATLA antibody and negative proviral DNA, indicating that these lymphoid cells had peripheral mature T cell phenotype. Lymphangiography showed no abnormal accumulation. The clinical diagnosis of T cell CLL was made.<br>In September 1982, she was noted splenomegaly without lymphadenopathy. WBC count increased remarkably and reached 420,000 per cmm with 98% lymphoid cells. Immunological natures of these lymphoid cells were similar to those of leukemic cells before crisis. Combined chemotherapy with vincristine, methotrexate, ACNU and prednisolone was ineffective and she died in November 1982.<br>At autopsy, the infiltration of lymphoid cells was observed in bone marrow, liver, spleen, kidney, thyroid glands and cerebrum, and no remarkable lymphadenopathy was seen.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 25 (2), 236-240, 1984

    The Japanese Society of Hematology

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