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Hodgkin's disease developing after spontaneous remission of chronic lymphocytic leukemia

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Abstract

We present a 71-year-old patient with chronic lymphocytic leukemia diagnosed 27 years ago. Initially, the disease was staged as Rai II and the patient suffered from secondary immunoglobulin deficiency. Nevertheless, no treatment was necessary at that time. Because of disease progression a single course of chemotherapy was given in 1984. During the following year there was a constant decline of the WBC, accompanied by normalization of the immunoglobulins; both have remained stable ever since that time. However, there was still residual bone marrow infiltration, indicating persisting CLL. In 1993 cervical lymphadenopathy occurred with acute onset. A diagnostic lymphadenectomy revealed Hodgkin's disease of the nodular-sclerosing subtype. The patient was staged as II–III according to the Ann Arbor Classification and underwent radiation therapy. Cytogenetic examination of the bone marrow revealed a normal karyotype with an inversion of chromosome 9. This case demonstrates the rare coincidence of two lymphoproliferative disorders in the same patient. The clinical course and the immunologic findings of this patient are presented, together with a review of the literature.

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References

  1. Schott M (1955) Ten-year recovery from chronic lymphocytic leukemia. Br Med J:877–879

    Google Scholar 

  2. Walter HL, Szur L, Lewis SM (1958) Prolonged remission in chronic lymphocytic leukemia. Br Med J:859–862

    Google Scholar 

  3. Reich C (1959) Apparent recovery in chronic lymphocytic leukemia. JAMA 170:169–171

    Google Scholar 

  4. Geller W (1964) Chronic lymphocytic leukemia with hemolytic anemia. Arch Intern Med 114:444–448

    Google Scholar 

  5. Durant JR, Finkenbeiner JA (1964) “Spontaneous” remission in chronic lymphocytic leukemia? Cancer 17:105–113

    Google Scholar 

  6. Bousser J, Zittoun R (1965) Remission spontanee prolongee d'une leucemie lymphoide chronique. Nouv Rev Fr Hematol 5:498–501

    Google Scholar 

  7. Chrevenick PA, Boggs DR, Wintrobe MM (1967) Spontaneous remission in chronic lymphocytic leukemia. Ann Intern Med 67:1239–1242

    Google Scholar 

  8. Han T, Ezdinli EZ, Sokal IE (1967) Complete remission in chronic lymphocytic leukemia and lymphosarcoma. Cancer 20:243–252

    Google Scholar 

  9. Han T, Sokal JE (1971) Spontaneous remission of leukemic lymphoproliferative disease. Cancer 27:586–595

    Google Scholar 

  10. Hansen RM, Libnoch JA (1978) Remission of chronic lymphocytic leukemia after smallpox vaccination. Arch Intern Med 138:1137–1138

    Google Scholar 

  11. Yettra M (1979) Remission of chronic lymphocytic leukemia after smallpox vaccination. Arch Intern Med 139:603

    Google Scholar 

  12. Blecher TE (1980) “Spontaneous” complete remission in a case of prolymphocytic leukemia. Br J Hematol 632:395–398

    Google Scholar 

  13. Hughes RG, Islam A, Lewis SM, Catovski D (1981) Spontaneous remission following bone marrow necrosis in chronic lymphocytic leukemia. Clin Lab Hematol 3:174–184

    Google Scholar 

  14. Büchi G, Termine G, Zappala C, Girotto M, Grosso E, Autino R (1983) Spontaneous complete remission of CLL. Acta Haematol 70:198–201

    Google Scholar 

  15. Neuland CY, Blattner WA, Mann DL, Fraser MC, Tsai S, Strong DM (1983) Familial chronic lymphocytic leukemia. J Natl Cancer Inst 71:1143–1149

    Google Scholar 

  16. Ribera JM, Vinolas N, Urbano-Ispizua A, Gallart T, Montserrat E, Rozman C (1987) “Spontaneous” complete remissions in chronic lymphocytic leukemia: report of three cases and review of the literature. Blood Cells 12:471–479

    Google Scholar 

  17. Holmes JA, Whittaker JA (1988) Spontaneous remission in chronic lymphocytic leukemia. Br J Haematol 69:97–99

    Google Scholar 

  18. Murakawa M, Shibuya T, Teshima T, Kudo J, Okamura T, Harada M, Nagafuchi S, Niho Y, Mukae Y (1990) Spontaneous remission from acute exacerbation of chronic adult T-cell leukemia. Blut 61:346–349

    Google Scholar 

  19. Frick S, Frick P (1993) Spontanremissionen bei chronischer lymphatischer Leukämie. Schweiz Med Wochenschr 123:328–334

    Google Scholar 

  20. Drobyski WR, Qaz R (1989) Spontaneous regression in non-Hodgkin's lymphoma: clinical and pathogenetic considerations. Am J Hematol 31:138–141

    Google Scholar 

  21. Han T, Ozer M, Gavigan M, Gajera R, Minowada J (1984) Benign monoclonal B-cell lymphocytosis-a benign variant of CLL: clinical, immunologic, phenotype and cytogenetic studies in 20 patients. Blood 64:244–252

    Google Scholar 

  22. Pisciotta AV, Hirschboeck JS (1957) Therapeutic considerations in chronic lymphocytic leukemia. Arch Intern Med 99:334

    Google Scholar 

  23. Oberfield RA (1966) Coexistence of chronic lymphocytic leukemia and Hodgkin's disease. JAMA 195:177–179

    Google Scholar 

  24. Johnson RE (1976) Total body irradiaton of chronic lymphocytic leukemia. Cancer 37:2691–2696

    Google Scholar 

  25. Tornyos K, Macossay CR, Gyorkey F (1967) Chronic lymphocytic leukemia and Hodgkin's disease in the same patient. Cancer 20:552–557

    Google Scholar 

  26. Howard-Peebles PN, Stoddard GR (1979) Pericentric inversions of chromosome number 9: benign or harmful? Hum Hered 29:111–117

    Google Scholar 

  27. Crossen PE (1989) Cytogenetic and molecular changes in chronic B-cell leukemia. Cancer Genet Cytogenet 43:143–150

    Google Scholar 

  28. Serra A, Brahe C, Millington-Ward A, Neri G, Tedeschi B, Tassone F, Bova R (1990) Pericentric inversion of chromosome 9: prevalence in 300 Down syndrome families and molecular studies of nondisjunction. Am J Med Genet [Suppl 7]:162–168

    Google Scholar 

  29. Atkin NB (1977) Chromosome 1 heteromorphism in patients with malignant disease: a constitutional marker for a high risk group? Br Med J 1:358

    Google Scholar 

  30. Kivi S, Mikelsaar AV (1987) C-band polymorphisms in lymphocytes of patients with ovarian or breast adenocarcinoma. Cancer Genet Cytogenet 28:77–85

    Google Scholar 

  31. Petkovic I, Nakic M, Konja J (1991) Heterochromatic variability in children with acute lymphoblastic leukemia. Cancer Genet Cytogenet 54:67–69

    Google Scholar 

  32. Sen P (1993) Chromosome 9 anomalies as the primary clonal alteration in a case of squamous cell carcinoma of the epiglottis. Cancer Genet Cytogenet 66:23–27

    Google Scholar 

  33. Labal de Vinuesa M, Slavutsky I, Mudry de Pargament M, Larripa I (1988) Heterochromatic variants and their association with neoplasias. V. Non-Hodgkin's lymphomas. Cancer Genet Cytogenet 31:175–178

    Google Scholar 

  34. Labal de Vinuesa M, Larripa I, Mudry de Pargament M, Brieux de Salum S (1985) Heterochromatic variants and their association with neoplasias. II. Preleukemic states. Cancer Genet Cytogenet 14:31–35

    Google Scholar 

  35. Petkovic I, Nakic M, Cepulic M, Tiefenbach A, Konja J (1985) Variability of chromosomes 1, 9, and 16 in children with malignant diseases. Cancer Genet Cytogenet 16:169–173

    Google Scholar 

  36. Adhvaryu SG, Dave BJ, Trivedi AH, Jani KH, Vyas RC (1987) Heteromorphisms of C-band positive chromosomal regions in CML patients. Cancer Genet Cytogenet 27:33–38

    Google Scholar 

  37. Labal de Vinuesa M, Larripa I, Mudry de Pargament M, Brieux de Salum S (1984) Heterochromatic variants and their association with neoplasias. I. Chronic and acute leukemia. Cancer Genet Cytogenet 13:297–302

    Google Scholar 

  38. Berger R, Bernheim A, Kristofferson U, Mitelman F, Olsson H (1985) C-band heteromorphism in breast cancer patients. Cancer Genet Cytogenet 18:37–42

    Google Scholar 

  39. Sampaio DA, Mattevi MS, Cavalli IJ, Erdtmann B (1989) Densitometric measurements of C-bands of chromosomes 1, 9, 16 and Y in leukmic and preleukemic disorders. Cancer Genet Cytogenet 41:71–78

    Google Scholar 

  40. Ranni SM, Labal de Vinuesa M, Mudry de Pargament M, Slavutsky I, Larripa I (1987) Heterochromatic variants and their association with neoplasia: III. Multiple myeloma. Cancer Genet Cytogenet 28:101–105

    Google Scholar 

  41. Labal de Vinuesa M, Mudry de Pargament M, Slavutsky I, Meiss R, Chopita N, Larripa I (1988) Heterochromatic variants and their association with neoplasia. IV. Colon adenomas and carcinomas. Cancer Genet Cytogenet 31:171–174

    Google Scholar 

  42. Shabtai F, Antebi E, Klar D, Kimchi D, Hart J, Halbrecht I (1985) Cytogenetic study of patients with carcinoma of the colon and rectum: particular C-band variants as possible markers for cancer proneness. Cancer Genet Cytogenet 14:235–245

    Google Scholar 

  43. Petkovic I (1983) Constitutive heterochromatin of chromosomes no. 1, 9 and 16 in 90 patients with malignant disease and 91 controls. Cancer Genet Cytogenet 151–158

  44. Foucar K, Rydell RE (1980) Richter's syndrome in chronic lymphocytic leukemia. Cancer 46:118

    Google Scholar 

  45. Long JC, Aisenberg AC (1975) Richter's syndrome. A terminal complication of chronic lymphocytic leukemia with distinct clinicopathologic features. Am J Clin Pathol 63:786–795

    Google Scholar 

  46. Splinter TAW, Bom-van Noorloos A, van Heerde P (1978) Chronic lymphocytic leukemia and diffuse histiocytic lymphoma in one patient: clonal proliferation of two different B cells. Scand J Hematol 20:29–36

    Google Scholar 

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Authors and Affiliations

  1. Department of Internal Medicine, Division of Hematology, University of Graz, Auenbruggerplatz 1, A-8036, Graz, Austria

    H. H. Schmidt, H. Sill, M. Eibl, G. J. Krejs & W. Linkesch

  2. Department of Pathology, University of Graz, Auenbruggerplatz 1, A-8036, Graz, Austria

    C. Beham-Schmid & G. Höfler

  3. St. Anna-Children's hospital, Kinderspitalgasse 6, A-1090, Vienna, Austria

    O. A. Haas

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  1. H. H. Schmidt
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Schmidt, H.H., Sill, H., Eibl, M. et al. Hodgkin's disease developing after spontaneous remission of chronic lymphocytic leukemia. Ann Hematol 71, 247–252 (1995). https://doi.org/10.1007/BF01744374

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  • DOI: https://doi.org/10.1007/BF01744374

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