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CC BY-NC-ND 4.0 · Avicenna J Med 2017; 07(03): 133-136
DOI: 10.4103/ajm.AJM_171_16
CASE REPORT

An unusual presentation of chronic lymphocytic leukemia

Dinesh Atwal
Department of Hematology Oncology, University of Arkansas for Medical Sciences, Winthrop Rockefeller Cancer Institute, Little Rock, Arkansas, USA
,
Mihir Raval
Department of Hematology Oncology, University of Arkansas for Medical Sciences, Winthrop Rockefeller Cancer Institute, Little Rock, Arkansas, USA
,
Belal Firwana
Department of Hematology Oncology, University of Arkansas for Medical Sciences, Winthrop Rockefeller Cancer Institute, Little Rock, Arkansas, USA
,
Jeanette Ramos
Department of Hematology Oncology, University of Arkansas for Medical Sciences, Winthrop Rockefeller Cancer Institute, Little Rock, Arkansas, USA
,
Appalanaidu Sasapu
Department of Hematology Oncology, University of Arkansas for Medical Sciences, Winthrop Rockefeller Cancer Institute, Little Rock, Arkansas, USA
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Abstract

Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is a B-cell lymphocytic neoplasm with indolent clinical course. If identified early, observation is opted. Many variables lead to the initiation of treatment. Authors describe a 62-year-old male presenting with shortness of breath and found to have white cell count of 1360 × 109/L and subsequently was diagnosed with CLL/SLL. The patient received leukapheresis along with tumor lysis treatment and systemic chemotherapy with fludarabine, cyclophosphamide, and rituximab regimen. His course was complicated with deep venous thrombosis, extensive cutaneous, and sinus mucosa involvement by CLL/SLL. The patient clinically improved and on follow-up clinic visits documented normalization of his white cell counts. The case report brings up a rare presentation of CLL/SLL with such an extreme high white cell count, leukostasis symptoms and extramedullary involvement of disease and encourages providers to be vigilant of rare presentation of CLL/SLL.

Keywords

Chronic lymphocytic leukemia - hyperleukocytosis - leukostasis


Publication History

Article published online:
09 August 2021

© 2017. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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