Secondary cutaneous infiltration in B cell chronic lymphocytic leukemia

• Published in: Acta haematologica Vol. 103; no. 2; p. 116
• Main Authors: Várkonyi, J, Zalatnai, A, Timár, J, Matolcsi, A, Falus, A, Bencsáth, M, László, V, Pócsik, E, Kotlán, B, Császár, A
• Format: Journal Article
• Language: English
• Published: Switzerland 01.01.2000
• Subjects: Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Chlorambucil - administration & dosage; Cyclophosphamide - administration & dosage; Doxorubicin - administration & dosage; Histidine Decarboxylase - deficiency; Humans; Immunologic Factors - therapeutic use; Interferon-alpha - therapeutic use; Leukemia, Lymphocytic, Chronic, B-Cell - diagnosis; Leukemia, Lymphocytic, Chronic, B-Cell - drug therapy; Leukemia, Lymphocytic, Chronic, B-Cell - enzymology; Leukemia, Lymphocytic, Chronic, B-Cell - pathology; Leukemic Infiltration; Lymphoma, B-Cell - diagnosis; Lymphoma, B-Cell - pathology; Lymphoma, Non-Hodgkin - diagnosis; Lymphoma, Non-Hodgkin - pathology; Male; Middle Aged; Neoplasm Proteins - deficiency; Prednisolone - administration & dosage; Prednisone - administration & dosage; Recombinant Proteins; Salvage Therapy; Skin - pathology; Vincristine - administration & dosage
• ISSN: 0001-5792
• DOI: 10.1159/000041031

We describe a patient presenting with B cell chronic lymphocytic leukemia (B-CLL) who subsequently developed cutaneous infiltrates. Specimens of the blood, bone marrow and cutaneous infiltrations all showed the same heavy-chain gene rearrangement. Following failure of conventional chemotherapy, and in view of the similarity of the disease to cutaneous T cell lymphoma, interferon-alpha therapy was employed with satisfactory results. Introduction of this cytokine to the therapeutic modalities for secondary cutaneous B-CLL would hopefully change the poor outcome of this entity, or at least could produce a better quality of life. Loss of histidine decarboxylase activity in the infiltrating cells - in contrast to circulating lymphocytes - may be associated with the transformation of B-CLL to a more aggressive infiltrative form, offering a possible explanation for tissue invasiveness. The changing character of the disease raises the possibility of a second mutational event in the course of B-CLL.