Abstract
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.
Copyright 2000 S. Karger AG, Basel
MeSH terms
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use
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Chlorambucil / administration & dosage
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Cyclophosphamide / administration & dosage
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Doxorubicin / administration & dosage
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Histidine Decarboxylase / deficiency
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Humans
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Immunologic Factors / therapeutic use
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Interferon alpha-2
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Interferon-alpha / therapeutic use
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Leukemia, Lymphocytic, Chronic, B-Cell / diagnosis
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Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy
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Leukemia, Lymphocytic, Chronic, B-Cell / enzymology
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Leukemia, Lymphocytic, Chronic, B-Cell / pathology*
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Leukemic Infiltration*
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Lymphoma, B-Cell / diagnosis
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Lymphoma, B-Cell / pathology*
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Lymphoma, Non-Hodgkin / diagnosis
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Lymphoma, Non-Hodgkin / pathology*
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Male
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Middle Aged
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Neoplasm Proteins / deficiency
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Prednisolone / administration & dosage
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Prednisone / administration & dosage
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Recombinant Proteins
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Salvage Therapy
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Skin / pathology*
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Vincristine / administration & dosage
Substances
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Immunologic Factors
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Interferon alpha-2
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Interferon-alpha
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Neoplasm Proteins
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Recombinant Proteins
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Chlorambucil
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Vincristine
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Doxorubicin
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Cyclophosphamide
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Prednisolone
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Histidine Decarboxylase
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Prednisone
Supplementary concepts
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CHOP protocol
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COP protocol 2