Association of myeloproliferative and lymphoproliferative disorders

摘要

Chintapatla and associates describe an interesting sequential association of essential thrombocythemia (ET) and chronic lymphocytic leukemia (CLL) in a patient exposed to asbestos. ET preceded CLL, and at the time of ET diagnosis, white blood cell (WBC) and differential counts were normal, as was the clinical examination. Subsequent testing for JAK2 V617F mutation, which was first described in 2005 as a marker of myeloproliferative disorders (MPD) and is observed in approximately 50% of ET cases, was negative. The patient responded to treatment with anagre-lide. A diagnosis of CLL was given 12 years later, based on lymphocytosis with B-cell phenotype, light chain restriction, and a nodular lymphocytic bone marrow infiltration. Lymphoproliferative disorder (LPD), evaluated as Rai stage 0 CLL, remains stable to date without treatment. This observation deserves several comments regarding the coexistence of MPD and LPD, its relation to genetic events, and the putative role of chronic inflammation.