DOCSLIB.ORG

Implications of Plasma Lymphoblastic Cells In

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Implications of Plasma Lymphoblastic Cells In REVIEW ARTICLE Implications of Plasma Lymphoblastic Cells in Lymphoreticular Disorders: An Overview Marin Abraham1 , SV Sowmya2 , Roopa S Rao3​,​Dominic​Augustine4 , Vanishri C Haragannavar5 ABSTRACT Aim: The aim of this review was to emphasize the diverse morphologic features of plasma lymphoblastic cells in lymphoreticular disorders to arrive at a precise diagnosis. Background: The lymphoreticular system comprises of a group of cells with a common lineage and primary function of immunoregulation. Specific immunity is achieved by the combined effects of macrophages and lymphocytes, and, therefore, it is the lymphoreticular system. These cells are scattered in different parts of the body and share some functional characteristics. At both functional and anatomical levels, lymphoreticular tissue can be categorized into primary and secondary lymphoid organs that predominantly produce lymphocytes and plasma cells. Review results: The plasma lymphoblastic lesions/malignancies comprise of characteristic cells like buttock cells, cells with irregular nuclei, cells with cleaved nuclear outlines, etc. Identification of such cells amidst sheets of malignant lymphoblastic cells is challenging. However, sound knowledge about the morphology of these cells and their immunohistochemical panel of markers may provide a clue for diagnosis. Conclusion: The predominant cell types noted in plasma lymphoblastic lesions histopathologically are immature lymphocytes and plasma cells in their varied cell activity suggest the biologic behavior of the lesion. Clinical significance: Understanding and identifying the normal and pathological cellular and nuclear morphology of the lymphoreticular cells can aid in the definitive diagnosis of the plasma lymphoblastic disorders and predict its biological nature. Keywords: Hematopoietic stem cells, Immunoglobulins, Lymphoreticular system, Lymphoblasts, Plasmablasts. World Journal of Dentistry (2019): 10.5005/jp-journals-10015-1636 INTRODUCTION 1–5 Department of Oral Pathology and Microbiology, M. S. Ramaiah The lymphoreticular system is distributed throughout the body, University of Applied Sciences, Bengaluru, Karnataka, India of which many of its cells originating from the hematopoietic stem Corresponding Author: Marin Abraham, Department of Oral cells, normally circulate in the peripheral blood and are involved Pathology and Microbiology, M. S. Ramaiah University of Applied in immune responses of various kinds including the synthesis Sciences, Bengaluru, Karnataka, India, Phone: +91 9880323479, e-mail: of immunoglobulins.1 Cells that constitute the lymphoreticular [email protected] system are bone marrow-derived cells that include lymphocytes, How to cite this article: Abraham M, Sowmya SV, et al. Implications monocytes, macrophages, and histiocytes. The white blood cells of Plasma Lymphoblastic Cells in Lymphoreticular Disorders: An originate from the lymphocytic and myelocytic lineages. The Overview. World J Dent 2019;10(3):241–245. lymphocytes and plasma cells are produced in the lymphogenous Source of support: Nil tissues namely the lymph glands, spleen, thymus, tonsils, bone Conflict of interest: None marrow, and payers patches.2 Two major lymphocyte populations, particularly those dependent on the presence of thymus gland (T cells) and those controlled by B cells, differentiate to form The proliferation of stem cells and its derivatives in circulating antibody-secreting cells. The plasma cells and memory B cells blood can cause enlargement of liver, spleen, and lymph nodes which represent an end stage and are responsible for humoral immunity, is characteristic in infections; however, an abnormal proliferation when appropriately sensitized T cells confer cell-mediated of cells in the lymphatic system, lymph, blood, and bone marrow immunity on host protecting from infections.3 Repeated can lead to hematopoietic and lymphoid malignancies.6 Neoplastic encounter of the same antigen triggers the rapid reactivation of disorders, although less frequent, are much more important to preexisting specific memory B cells, which then potentially enter manage clinically. Abnormal proliferations of plasmablasts are new germinal center reactions and differentiate into short-lived recognized in immunodeficient and immunocompetent conditions, plasmablasts or remain in the system as memory B cells.4 whereas aberrance in immature lymphocytes is a typical feature in The predominant precursors of the lymphoreticular system leukemia and lymphomas.4 , 7 include lymphoblasts and the plasmablasts. Lymphoblasts are about Histological findings, blood picture, and biochemical 10–18 μm in size, with a large or oval nucleus and a stippled and alterations are best considered as different facets of a single clumped nuclear chromatin. They are rapidly dividing in nature and underlying disease process.1, 8 The malignancies encountered due are the earliest detectable precursor of lymphoid cells. Plasmablasts to the abnormal proliferation of lymphoblasts and plasmablasts have a round to oval morphology, measuring about 15–25 μm with exhibit heterogeneity and versatile histopathological a basophilic cytoplasm more marked in the periphery than in the presentations. In the present review, the plasma lymphoblastic center (Table 1).5 cells with characteristic cellular and nuclear pleomorphisms © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons. org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. An overview on Plasma Lymphoblastic Cells in Lymphoreticular Disorders Table 1: Summary of characteristic cellular and nuclear pleomorphisms in various lymphoreticular disorders Immunohistochemical Characteristic cells Lymphoreticular disorders Characteristic morphologic features Clinical significance panel/markers Cells with con- Mantle cell lymphoma Small lymphocytes with dense Increased mitotic rate4 , 9 SOX1110 densed chromatin Small B cell lymphocytic chromatin condensation (Fig. 1) lymphoma Peripheral T cell lymphoma Cells with prominent Large B cell lymphoma Dispersed chromatin Increased mitotic rate Large B cell lymphoma- nucleoli (Fig. 1) stathmin10 Small B cell lymphocytic More basophilic due to abundant Increased protein synthesis T cell lymphoma [not lymphoma rough endoplasmic reticulum and cell activity otherwise specified Peripheral T cell (RER)4 , 9 (NOS)]-CD311 lymphoma Cell with cleaved Follicular lymphoma Indented nuclei Infrequent mitosis Cluster of differentia- nuclear outlines Rate of growth is slow4 , 9 tion 10 (CD10), B cell (Fig. 1) lymphoma 6 protein (BCL6), human germi- nal center associated lymphoma (HGAL), LIM only transcription factor 2 (LMO2), and stathmin10 Irregular nuclei/ Acute lymphoblastic These cells are large and heterogene- Increased mitotic rate CD10, BCL6, HGAL, agranular cytoplasm leukemia ous showing irregular nuclear shape Aggressive nature4 , 9 LMO2, and stathmin10 (Fig. 2) with variable nuclear chromatin, cytoplasmic content, and basophilia4 , 9 Plasmacytoid lym- Plasmacytoma More abundant cytoplasm Presence of immunoglobulin CD2012 phocytes (Fig. 2A) Development of RER in cytoplasm on tumor cell surface and Increased RNA acids exhibiting within the cytoplasm in some 4,9 amphophilic/basophilic cytoplasm cases Presence of clumped chromatin in the nucleus against nuclear membrane Classical Reed Hodgkin’s lymphoma Multinucleated/binucleated cells There is increase in deoxy- CD30 and CD156 Sternberg (RS) cells with an amphophilic cytoplasm ribonucleic acid content (Fig. 2B) and large and prominent nucleoli proportionate to number of (owl-eye appearance) nuclear lobes The nuclei undergoes endomitosis and polyploidization4 , 9 Plasmacytic plasma- Plasmacytoma Pleomorphism of plasma cells Presence of excess of immu- CD20, CD138, and blasts (Fig. 2A) noglobulin in the blood CD5613 Multiple myelomas Presence of plasma cells in clumps Mitosis is uncommon4 , 9 and sheets Presence of Mott cells Abnormal synthesis, traffick- ing, or excretion of the immu- noglobulin that is stored in excess within the cytoplasm14 Presence of flame cells Horse-shoe-shaped Anaplastic large cell Typical hallmark tumor cells with Aggressive lesion CD3015 nuclei (Fig. 3B) lymphoma lobulated (embryo-like) nuclei and a Increased mitotic rate4 , 9 prominent nucleolus Dutcher bodies Lymphoplasmacytoid Cytoplasmic inclusions that are Accumulation of IgM in cyto- CD20, CD79a, and (Fig. 3A) lymphoma either invaginated into or are plasm of plasmalymphocytic PAX516 overlying the nucleus cells MALT lymphoma Increase in protein content4 , 9 Buttock cells Follicular lymphoma, Separate nuclear lobes connected Increased mitotic rate4 , 9 CD10, BCL6, HGAL, (Fig. 2A) mycosis fungoides, and by chromatin LMO2, and stathmin10 Sézary syndrome Villous lymphocytes Splenic lymphoma, hairy Monomorphic lymphoid cells with Beta actin expression that CD1917 (Fig. 3C) cell leukemia poorly defined cytoplasm is polymerized to F actin in cortical cytoskeleton16 Contd... 242 World​Journal​of​Dentistry,​Volume​10​Issue​3​(May–June​2019) An overview
Load more

Recommended publications
  • Clinical Utility of Recently Identified Diagnostic, Prognostic, And
    Modern Pathology (2017) 30, 1338–1366 1338 © 2017 USCAP, Inc All rights reserved 0893-3952/17 $32.00 Clinical utility of recently identified diagnostic, prognostic, and predictive molecular biomarkers in mature B-cell neoplasms Arantza Onaindia1, L Jeffrey Medeiros2 and Keyur P Patel2 1Instituto de Investigacion Marques de Valdecilla (IDIVAL)/Hospital Universitario Marques de Valdecilla, Santander, Spain and 2Department of Hematopathology, MD Anderson Cancer Center, Houston, TX, USA Genomic profiling studies have provided new insights into the pathogenesis of mature B-cell neoplasms and have identified markers with prognostic impact. Recurrent mutations in tumor-suppressor genes (TP53, BIRC3, ATM), and common signaling pathways, such as the B-cell receptor (CD79A, CD79B, CARD11, TCF3, ID3), Toll- like receptor (MYD88), NOTCH (NOTCH1/2), nuclear factor-κB, and mitogen activated kinase signaling, have been identified in B-cell neoplasms. Chronic lymphocytic leukemia/small lymphocytic lymphoma, diffuse large B-cell lymphoma, follicular lymphoma, mantle cell lymphoma, Burkitt lymphoma, Waldenström macroglobulinemia, hairy cell leukemia, and marginal zone lymphomas of splenic, nodal, and extranodal types represent examples of B-cell neoplasms in which novel molecular biomarkers have been discovered in recent years. In addition, ongoing retrospective correlative and prospective outcome studies have resulted in an enhanced understanding of the clinical utility of novel biomarkers. This progress is reflected in the 2016 update of the World Health Organization classification of lymphoid neoplasms, which lists as many as 41 mature B-cell neoplasms (including provisional categories). Consequently, molecular genetic studies are increasingly being applied for the clinical workup of many of these neoplasms. In this review, we focus on the diagnostic, prognostic, and/or therapeutic utility of molecular biomarkers in mature B-cell neoplasms.
    [Show full text]
  • ©Ferrata Storti Foundation
    Lymphoproliferative Disorders original paper haematologica 2001; 86:1046-1050 Efficacy of anti-CD20 monoclonal http://www.haematologica.it/2001_10/1046.htm antibodies (Mabthera) in patients with progressed hairy cell leukemia FRANCESCO LAURIA, MARIAPIA LENOCI, LUCIANA ANNINO,* DONATELLA RASPADORI, GIUSEPPE MAROTTA, MONICA BOCCHIA, FRANCESCO FORCONI, SARA GENTILI, MICHELA LA MANDA,* SILVIA MARCONCINI, MONICA TOZZI, LUCA BALDINI,# PIER LUIGI ZINZANI,° ROBIN FOÀ* Department of Hematology, University of Siena; *Department of Hematology, University “La Sapienza”, Rome; °Institute of Correspondence: Francesco Lauria, MD, Department of Hematology “A. Sclavo” Hospital, via Tufi 1, 53100 Siena, Italy. Hematology and Clinical Oncology “Seragnoli”, University of Phone: international +39.0577.586798. Bologna; #Centro G. Marcora, University of Milan, Italy Fax: international +39.0577.586185. E-mail: [email protected] Background and Objectives. Recently, a chimeric Interpretation and Conclusions. On the basis of monoclonal antibody (MoAb) directed against the these preliminary results observed in 10 patients CD20 antigen (rituximab) has been successfully with progressed HCL, it appears that treatment with introduced in the treatment of several CD20-posi- anti-CD20 MoAb is safe and effective in at least tive B-cell neoplasias and particularly of follicular 50% of patients, particularly in those with a less lymphomas. Based on these premises we evaluat- evident bone marrow infiltration (≤ 50%) and in ed the efficacy and the toxicity of chimeric those previously
    [Show full text]
  • Indolent Non-Hodgkin's Lymphomas
    Follicular and Low-Grade Non-Hodgkin Lymphomas (Indolent Lymphomas) Stefan K Barta, M.D., M.S. Associate Professor of Medicine Leader, T Cell Lymphoma Program Perelman Center for Advanced Medicine Facts and Figures: Non-Hodgkin Lymphomas • Most common blood cancer • 7th most common cancer in the US3 • 71,850 new cases in the US in 20151 • 19,790 died of NHL in 20151 • About 549,625 people are living with a history of NHL (2012)1 • 85% of all NHLs are B-cell lymphomas2 • Follicular lymphoma = 2nd most common type, ~25% of all NHLs4 1 http://seer.cancer.gov/statfacts/html/nhl.html. 2 ACS. Detailed Guide (revised January 21, 2000): Non-Hodgkin’s Lymphoma. 3 http://www.cancer.gov/cancertopics/types/commoncancers 4 Blood 89: 3909, 1997 The Immune System T- CELLS B- CELLS Cellular immunity: Humoral immunity: helper + cytotoxic T-cells antibodies Lymphatic System Lymph Node Anatomy Lymph Node: Microscopic View germinal center Lymphocyte: Microscopic View Causes Possible cause(s): • chemical exposures (pesticides, fertilizers or solvents) • individuals with compromised immune systems • heredity • infections (e.g. H. pylori, Hep C, chlamydia trachomatis) • most patients have no clear risk factors • IN MOST CASES, THE EXACT CAUSE IS UNKNOWN Cellular Origins of Lymphomas & Leukemias PLEURIPOTENT STEM CELL ACUTE LEUKEMIAS LYMPHOID STEM CELL ACUTE LYMPHOBLASTIC LEUKEMIAS PRECURSOR T - CELL PRECURSOR B - CELL LYMPHOBLASTIC LYMPHOMAS / LEUKEMIAS MATURE T - CELL MATURE B - CELL NON-HODGKIN LYMPHOMAS / CHRONIC LYMPHOCYTIC LEUKEMIA LYMPH NODES, EXTRANODAL
    [Show full text]
  • Hairy Cell Leukemia: the Good News of a Bad Disease
    CASO CLÍNICO Hairy Cell Leukemia: the good news of a bad disease Mónica Seidi, Guadalupe Benites, Almerindo Rego Hospital de Santo Espírito da Ilha Terceira Abstract Hairy Cell Leukemia (HCL) is an uncommon chronic B cell Lymphoproliferative disorder characterized by the accumulation of a small mature B cell lym- phoid cells with abundant cytoplasm and “hairy” projections within the peripheral blood smear, bone marrow and splenic red pulp. Most patients with HCL present with symptons related to splenomegaly or cytopenias, including some constitucional symptons, however one quarter of them is asymptomatic and is referred due to incidental findings. The authors decided to report a clinical case of hairy cells leukemia in an asymptomatic patient due to the rarity of this neoplasia (2% of all leukemias Galicia Clínica | Sociedade Galega de Medicina Interna and less than 1% of limphoids neoplasms) and because it corresponds to the most successfully treatable leukemia. Palabras clave: Citopenias. Esplenomegalia. Enfermedad linfoproliferativa. Leucemia de células peludas. Keywords: Cytopenias. Splenomegaly. Lymphoproliferative disease. Hairy cells leukemia Introduction clonal gamma peak. The CT abdominal scan revealed homogenea Hairy cell leukemia (HCL) is an uncommon B-cell lymphopro- splenomegaly with no limphadenopathy present. liferative disorder that affects adults, and was first reported We decided to admit the patient in the ward to perform invasive exams such as a bone marrow aspiration which showed 66% of as a distinct disease in 1958
    [Show full text]
  • Hairy Cell Leukemia
    Hairy Cell Leukemia No. 16 in a series providing the latest information for patients, caregivers and healthcare professionals Introduction Highlights Hairy cell leukemia (HCL) is a rare, slow-growing y Hairy cell leukemia (HCL) is a rare, leukemia that starts in a B cell (B lymphocyte). B cells are slow-growing leukemia that starts in a B cell white blood cells that help the body fight infection and (also called B lymphocyte), a type of white are an important part of the body’s immune system. blood cell. Changes (mutations) in the genes of a B cell can cause it y Changes (mutations) in the genes of a to develop into a leukemia cell. Normally, a healthy B cell B cell can cause it to develop into a leukemia would stop dividing and eventually die. In HCL, genetic cell. In HCL, leukemic B cells are overproduced errors tell the B cell to keep growing and dividing. Every and infiltrate the bone marrow and spleen. cell that arises from the initial leukemia cell also has the They may also be found in the liver and lymph mutated DNA. As a result, the leukemia cells multiply nodes. These excess B cells are abnormal uncontrollably. They usually go on to infiltrate the bone and have projections that look like hairs marrow and spleen, and they may also invade the liver under a microscope. and lymph nodes. The disease is called “hairy cell” y Signs and symptoms of HCL include an leukemia because the leukemic cells have short, thin enlarged spleen and a decrease in normal projections on their surfaces that look like hairs when blood cell counts.
    [Show full text]
  • Cancer Association of South Africa (CANSA) Fact Sheet on Adult Hairy Cell Leukaemia
    Cancer Association of South Africa (CANSA) Fact Sheet on Adult Hairy Cell Leukaemia Introduction Leukaemia is a cancer of the blood forming system. Most types of leukaemia cause the bone marrow to make abnormal white blood cells. These abnormal cells can get into the bloodstream and circulate around the body. [Picture Credit: Hairy Cell Leukaemia] Adult Hairy Cell Leukaemia (HCL) Hairy cell leukaemia is a rare, slow-growing cancer of the blood in which the bone marrow makes too many B cells (lymphocytes), a type of white blood cell that fights infection. These excess B cells are abnormal and look "hairy" under a microscope. As the number of leukaemia cells increases, fewer healthy white blood cells, red blood cells and platelets are produced. This disease affects more men than women, and it occurs most commonly in middle-aged or older adults. It is considered a chronic disease because it may never completely disappear, although treatment can lead to remission for years. Joshi, A., Dhanushkodi, M., Ganesan, P., Radhakrishnan, V., Kannan, K., Mehra, N., Kalaiyarasi, J.P., Krupashankar, S., Sundersingh, S., Ganesan, T.S. & Sagar, T.G. 2020. “HCL is an uncommon B cell lympho-proliferative disorder with high remission rates. There is paucity of data on the long-term outcome of HCL from India. We retrospectively collected data from individual case records of patients with HCL who were treated in Cancer Institute, Chennai from January 2001 until January 2018. Sixteen patients were diagnosed with HCL and were treated with cladribine (81%), interferon (13%) and one patient received only best supportive care (6%).
    [Show full text]
  • Update on Hairy Cell Leukemia Robert J
    Update on Hairy Cell Leukemia Robert J. Kreitman, MD, and Evgeny Arons, PhD The authors are affiliated with the Abstract: Hairy cell leukemia (HCL) is a chronic B-cell malignancy with National Cancer Institute’s Center for multiple treatment options, including several that are investigational. Cancer Research at the National Institutes Patients present with pancytopenia and splenomegaly, owing to the of Health in Bethesda, Maryland. Dr infiltration of leukemic cells expressing CD22, CD25, CD20, CD103, Kreitman is a senior investigator in the Laboratory of Molecular Biology and tartrate-resistant acid phosphatase (TRAP), annexin A1 (ANXA1), and the head of the clinical immunotherapy the BRAF V600E mutation. A variant lacking CD25, ANXA1, TRAP, section, and Dr Arons is a staff scientist in and the BRAF V600E mutation, called HCLv, is more aggressive and the Laboratory of Molecular Biology. is classified as a separate disease. A molecularly defined variant expressing unmutated immunoglobulin heavy variable 4-34 (IGHV4- 34) is also aggressive, lacks the BRAF V600E mutation, and has a Corresponding author: Robert J. Kreitman, MD phenotype of HCL or HCLv. The standard first-line treatment, which Laboratory of Molecular Biology has remained unchanged for the past 25 to 30 years, is single-agent National Cancer Institute therapy with a purine analogue, either cladribine or pentostatin. This National Institutes of Health approach produces a high rate of complete remission. Residual traces 9000 Rockville Pike of HCL cells, referred to as minimal residual disease, are present in Building 37, Room 5124b most patients and cause frequent relapse. Repeated treatment with Bethesda, MD 20892-4255 Tel: (301) 648-7375 a purine analogue can restore remission, but at decreasing rates and Fax: (301) 451-5765 with increasing cumulative toxicity.
    [Show full text]
  • Hairy Cell Leukemia with Marked Lymphocytosis
    Hairy Cell Leukemia With Marked Lymphocytosis Brian Patrick Adley, MD; Xiaoping Sun, MD, PhD; John M. Shaw, MD; Daina Variakojis, MD airy cell leukemia (HCL) is a rare small B-cell lym- H phoproliferative disorder. The neoplastic cells have round to oval nuclei and abundant cytoplasm with ``hairy'' projections seen in the peripheral blood and bone marrow. They typically diffusely in®ltrate bone marrow and spleen. Immunophenotypically, they strongly express CD103, CD22, CD11c, and CD25. Hairy cell leukemia commonly presents with pancytopenia and splenomegaly with few circulating neoplastic cells. We describe the case of a 42-year-old man who presented at our institution with marked leukocytosis (white blood cell count, 98 300/mL) and splenomegaly. The patient had no signi®cant past medical history. His hemoglobin level was 9.9 g/dL and his platelet count was 154 000/mL. Review of a peripheral blood smear demon- strated marked lymphocytosis consisting of larger than usual lymphocytes with round to oval, eccentrically locat- ed nuclei; small inconspicuous nucleoli; and relatively abundant cytoplasm (Figure 1). Most of the lymphocytes displayed cytoplasmic projections (Figure 1, inset). Many of the cells were tartrate-resistant acid phosphatase (TRAP) positive (Figure 2). A normochromic, normocytic anemia with occasional ovalocytes and teardrop cells was also noted. The bone marrow core biopsy was markedly hypercellular (90%), with most of the medullary space oc- cupied by small to medium-sized, monotonous-appearing lymphocytes with abundant cytoplasm (Figure 3). Flow cytometric analysis performed on the bone marrow aspi- rate demonstrated these cells to be k-light chain restricted and CD191, CD201, CD52, CD102, CD11c1, CD1031,and CD251.
    [Show full text]
  • Chronic Lymphocytic Leukemia Early Detection, Diagnosis, and Staging Detection and Diagnosis
    cancer.org | 1.800.227.2345 Chronic Lymphocytic Leukemia Early Detection, Diagnosis, and Staging Detection and Diagnosis Finding cancer early often allows for more treatment options. Some early cancers may have signs and symptoms that can be noticed, but that's not always the case. ● Can Chronic Lymphocytic Leukemia Be Found Early? ● Signs and Symptoms of Chronic Lymphocytic Leukemia ● How Is Chronic Lymphocytic Leukemia Diagnosed? Stages and Outlook (Prognosis) After a cancer diagnosis, staging provides important information about the extent of cancer in the body and anticipated response to treatment. ● How Is Chronic Lymphocytic Leukemia Staged? Questions to Ask About CLL Here are some questions you can ask your cancer care team to help you better understand your CLL diagnosis and treatment options. ● Questions to Ask About Chronic Lymphocytic Leukemia 1 ____________________________________________________________________________________American Cancer Society cancer.org | 1.800.227.2345 Can Chronic Lymphocytic Leukemia Be Found Early? For certain cancers, the American Cancer Society recommends screening tests1 in people without any symptoms, because they are easier to treat if found early. But for chronic lymphocytic leukemia (CLL) , no screening tests are routinely recommended at this time. Many times, CLL is found when routine blood tests are done for other reasons. For instance, a person's white blood cell count may be very high, even though he or she doesn't have any symptoms. If you notice any symptoms that could be caused by CLL, report them to your doctor right away so the cause can be found and treated, if needed. Hyperlinks 1. www.cancer.org/healthy/find-cancer-early/cancer-screening-guidelines/american- cancer-society-guidelines-for-the-early-detection-of-cancer.html Last Revised: May 10, 2018 Signs and Symptoms of Chronic Lymphocytic Leukemia Many people with chronic lymphocytic leukemia (CLL) do not have any symptoms when it is diagnosed.
    [Show full text]
  • An Unusual Hematopoietic Stem Cell Transplantation for Donor Acute Lymphoblastic Leukemia: a Case Report
    Zhou et al. BMC Cancer (2020) 20:195 https://doi.org/10.1186/s12885-020-6681-2 CASE REPORT Open Access An unusual hematopoietic stem cell transplantation for donor acute lymphoblastic leukemia: a case report Di Zhou†, Ting Xie†, Suning Chen2, Yipeng Ling1, Yueyi Xu1, Bing Chen1, Jian Ouyang1 and Yonggong Yang1* Abstract Background: Donor acute lymphoblastic leukemia with recipient intact is a rare condition. We report a case of donor developing acute lymphoblastic leukemia 8 yrs after donating both bone marrow and peripheral blood hematopoietic stem cells. Case presentation: This case report describes a 51-year old female diagnosed with acute lymphoblastic leukemia who donated both bone marrow and peripheral blood stem cells 8 yrs ago for her brother with severe aplastic anemia. Whole exome sequencing revealed leukemic genetic lesions (SF3B1 and BRAF mutation) only appeared in the donor sister, not the recipient, and an unusual type of hematopoietic stem cell transplantation with the recipient’s peripheral blood stem cells was done. The patient remained in remission for 3 months before disease relapsed. CD19 CAR-T therapy followed by HLA-identical unrelated hematopoietic stem cell transplantation was applied and the patient remains in remission for 7 months till now. Conclusions: This donor leukemia report supports the hypothesis that genetic lesions happen randomly in leukemogenesis. SF3B1 combined with BRAF mutation might contribute to the development of acute lymphoblastic leukemia. Keywords: Donor leukemia, Acute lymphoblastic leukemia, Hematopoietic stem cell transplantation, SF3B1, BRAF Background healthy donor cells in recipients [3–6]. The latter one is Donor leukemia is a rare condition and only anecdotal unpredictable but it takes up the majority of DCL.
    [Show full text]
  • Epidemiology of Hairy Cell Leukemia (HCL) and HCL-Like Disorders Author Xavier Troussard
    Xavier Troussard. Medical Research Archives vol 8 issue 10. Medical Research Archives RESEARCH ARTICLE Epidemiology of Hairy Cell Leukemia (HCL) and HCL-Like Disorders Author Xavier Troussard Laboratoire hématologie, CHU Côte de Nacre, 14033 Caen Cedex 9 [email protected] Tel: +33 2 31 06 50 38 Abstract Hairy cell leukemia (HCL) is a very rare and well-defined entity that is characterized by the presence of hairy cells expressing the characteristic markers CD11c, CD25, CD103 and CD123 and in most cases by the presence of the BRAFV600E mutation. The incidence rate, directly adjusted to the 2000 United States standard population is estimated at 0.62 per 100 000 person-years (PA) in white men, 0.21 in black men, 0.20 in Asian men and 0.06 American Indian or Alaska native men. Based on the estimated 2019 leukemia incidence, of 61,780 in the United States, approximately 1,240 new HCL cases are expected per year, with only 60–75 new patients having a variant form of HCL each year. In France, the median age of patients at diagnosis is 63 years in men and 59 years in women. There is a strong male predominance, with a sex ratio of 5:1. HCL is a malignant disorder with a good prognosis, with a standardized average survival at 1 year and 5 years of 95% (95% CI: 91-97 for both). The etiology of HCL remains unknown. The risk of secondary cancers is high, especially that of another malignant hematologic disorder. This high risk justifies the need for prolonged hematological monitoring.
    [Show full text]
  • 2.03.502 Monoclonal Antibodies for the Treatment of Lymphoma
    MEDICAL POLICY – 2.03.502 Monoclonal Antibodies for the Treatment of Lymphoma BCBSA Ref. Policy: 2.03.05 Effective Date: Sept. 1, 2021 RELATED MEDICAL POLICIES: Last Revised: Aug. 3, 2021 5.01.549 Off-Label Use of Drugs and Biologic Agents Replaces: N/A 5.01.550 Pharmacotherapy of Arthropathies 5.01.556 Rituximab: Non-oncologic and Miscellaneous Uses 8.01.533 Radioimmunotherapy in the Treatment of Non-Hodgkin Lymphoma Select a hyperlink below to be directed to that section. POLICY CRITERIA | DOCUMENTATION REQUIREMENTS | CODING RELATED INFORMATION | EVIDENCE REVIEW | REFERENCES | HISTORY ∞ Clicking this icon returns you to the hyperlinks menu above. Introduction An antibody is a blood protein. When the immune system detects an unhealthy cell, antibodies attach themselves to a molecule known as an antigen on that unhealthy cell. The antibody then acts as flag for other immune system cells, causing those other immune system cells to swarm to the area and fight the unhealthy cell. Cancer cells can evade the immune system by reproducing very quickly, avoiding detection, or completely blocking the immune system. Monoclonal antibodies are drugs that work with the body’s natural immune response. Monoclonal antibodies are produced in a laboratory and made to specifically attach to the antigens which are typically found in high numbers on cancer cells. This policy describes when treatment with monoclonal antibodies may be approved to treat lymphoma. Note: The Introduction section is for your general knowledge and is not to be taken as policy coverage criteria. The rest of the policy uses specific words and concepts familiar to medical professionals.
    [Show full text]