DETECTION AND MONITORING OF A CONCOMITANT ATYPICAL MYELOPROLIFERATIVEDISORDER AND CHRONIC LYMPHOCYTIC-LEUKEMIA BY FLOW-CYTOMETRIC IMMUNOPHENOTYPING

Objective.-To illustrate the utility of a broad panel of monoclonal an tibodies to detect secondary processes or unexpected characteristics o f the primary blood dyscrasia. Design.-Case report and discussion. Set ting.-Regional academic medical center. Patient.-A 64-year-old man pre senting with an apparent acute myeloid leukemia.Interventions.-Sequent ial immunophenotyping with a broad panel of monoclonal antibodies to m onitor progression of disease and response to therapy. Main outcome me asure.-ldentification and monitoring of the two atypical populations i n this patient with correlation to the clinical status of the patient. Results.-ldentification of an unsuspected mature lymphoid clone and c haracterization of the evolution of the myelomonocytic clone. Conclusi on.-The evolving mature lymphoid clone may have been overlooked in the context of a predominant atypical myeloproliferative process, particu larly if a limited panel of monoclonal antibodies had been used for im munophenotyping. Sequential immunophenotyping was useful in monitoring the progression of each atypical process.