HODGKINS-DISEASE DEVELOPING AFTER SPONTANEOUS REMISSION OF CHRONIC LYMPHOCYTIC-LEUKEMIA

We present a 71-year-old patient with chronic lymphocytic leukemia dia gnosed 27 years ago. Initially, the disease was staged as Rai II and t he patient suffered from secondary immunoglobulin deficiency. Neverthe less, no treatment was necessary at that time. Because of disease prog ression a single course of chemotherapy was given in 1984. During the following year there was a constant decline of the WBC, accompanied by normalization of the immunoglobulins; both have remained stable ever since that time. However, there was still residual bone marrow infiltr ation, indicating persisting CLL. In 1993 cervical lymphadenopathy occ urred with acute onset. A diagnostic lymphadenectomy revealed Hodgkin' s disease of the nodular-sclerosing subtype. The patient was staged as II-III according to the Ann Arbor Classification and underwent radiat ion therapy. Cytogenetic examination of the bone marrow revealed a nor mal karyotype with an inversion of chromosome 9. This case demonstrate s the rare coincidence of two lymphoproliferative disorders in the sam e patient. The clinical course and the immunologic findings of this pa tient are presented, together with a review of the literature.