Refractory chronic lymphocytic leukemia with concomitant extramedullary multiple myeloma with lymph node involvement

Concomitant chronic lymphocytic leukemia (CLL) and multiple myeloma (MM) in the same patient is extremely rare. In this report, we present an unprecedented case of a patient with a history of progressive, purine analog-resistant CLL, who developed extramedullary malignant plasmacytic infiltrates in...

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Main Authors: Piotr Jachimowski, Łukasz Ciulkiewicz, Bogna Ziarkiewicz-Wróblewska, Laretta Grabowska-Derlatka, Grzegorz Basak, Mateusz Ziarkiewicz
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Current Problems in Cancer: Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666621924000474
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author Piotr Jachimowski
Łukasz Ciulkiewicz
Bogna Ziarkiewicz-Wróblewska
Laretta Grabowska-Derlatka
Grzegorz Basak
Mateusz Ziarkiewicz
author_facet Piotr Jachimowski
Łukasz Ciulkiewicz
Bogna Ziarkiewicz-Wróblewska
Laretta Grabowska-Derlatka
Grzegorz Basak
Mateusz Ziarkiewicz
author_sort Piotr Jachimowski
collection DOAJ
description Concomitant chronic lymphocytic leukemia (CLL) and multiple myeloma (MM) in the same patient is extremely rare. In this report, we present an unprecedented case of a patient with a history of progressive, purine analog-resistant CLL, who developed extramedullary malignant plasmacytic infiltrates in lymph nodes on the background of preexisting CLL lesions, presenting with clinical sequelae attributable to active MM (hypercalcemia, renal insufficiency, anemia, bone lesions). We administered R-CHOP with bortezomib with partial remission and both CLL and MM relapsed after one month. Our patient deceased three months later. Surprisingly first bone marrow trephine biopsy did not reveal plasmacytic infiltration. However combination of symptoms presented by our patient should always be an indication for repeating biopsy. Early detection of aggressive multiple myeloma can improve prognosis and prolong survival.
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publisher Elsevier
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series Current Problems in Cancer: Case Reports
spelling doaj-art-987fe5b017ec46fc9ba9686e73dae80d2025-08-20T02:17:59ZengElsevierCurrent Problems in Cancer: Case Reports2666-62192024-12-011610032410.1016/j.cpccr.2024.100324Refractory chronic lymphocytic leukemia with concomitant extramedullary multiple myeloma with lymph node involvementPiotr Jachimowski0Łukasz Ciulkiewicz1Bogna Ziarkiewicz-Wróblewska2Laretta Grabowska-Derlatka3Grzegorz Basak4Mateusz Ziarkiewicz5Department of Hematology, Transplantology and Internal Diseases, Medical University of Warsaw, Warsaw, PolandDepartment of Hematology, Transplantology and Internal Diseases, Medical University of Warsaw, Warsaw, PolandDepartment of Pathomorphology, Medical University of Warsaw, Warsaw, PolandDepartment of Radiology, Medical University of Warsaw, Warsaw, PolandDepartment of Hematology, Transplantology and Internal Diseases, Medical University of Warsaw, Warsaw, PolandDepartment of Hematology, Transplantology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland; Corresponding author: Mateusz Ziarkiewicz, Department of Hematology, Transplantology and Internal Diseases, Medical University of Warsaw, 02-097 Warsaw, ul. Banacha 1A, Poland.Concomitant chronic lymphocytic leukemia (CLL) and multiple myeloma (MM) in the same patient is extremely rare. In this report, we present an unprecedented case of a patient with a history of progressive, purine analog-resistant CLL, who developed extramedullary malignant plasmacytic infiltrates in lymph nodes on the background of preexisting CLL lesions, presenting with clinical sequelae attributable to active MM (hypercalcemia, renal insufficiency, anemia, bone lesions). We administered R-CHOP with bortezomib with partial remission and both CLL and MM relapsed after one month. Our patient deceased three months later. Surprisingly first bone marrow trephine biopsy did not reveal plasmacytic infiltration. However combination of symptoms presented by our patient should always be an indication for repeating biopsy. Early detection of aggressive multiple myeloma can improve prognosis and prolong survival.http://www.sciencedirect.com/science/article/pii/S2666621924000474MM, CLL, Secondary malignancy, Prolymphocytic progressionNodal plasmacytoma
spellingShingle Piotr Jachimowski
Łukasz Ciulkiewicz
Bogna Ziarkiewicz-Wróblewska
Laretta Grabowska-Derlatka
Grzegorz Basak
Mateusz Ziarkiewicz
Refractory chronic lymphocytic leukemia with concomitant extramedullary multiple myeloma with lymph node involvement
Current Problems in Cancer: Case Reports
MM, CLL, Secondary malignancy, Prolymphocytic progression
Nodal plasmacytoma
title Refractory chronic lymphocytic leukemia with concomitant extramedullary multiple myeloma with lymph node involvement
title_full Refractory chronic lymphocytic leukemia with concomitant extramedullary multiple myeloma with lymph node involvement
title_fullStr Refractory chronic lymphocytic leukemia with concomitant extramedullary multiple myeloma with lymph node involvement
title_full_unstemmed Refractory chronic lymphocytic leukemia with concomitant extramedullary multiple myeloma with lymph node involvement
title_short Refractory chronic lymphocytic leukemia with concomitant extramedullary multiple myeloma with lymph node involvement
title_sort refractory chronic lymphocytic leukemia with concomitant extramedullary multiple myeloma with lymph node involvement
topic MM, CLL, Secondary malignancy, Prolymphocytic progression
Nodal plasmacytoma
url http://www.sciencedirect.com/science/article/pii/S2666621924000474
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