Acute myeloid leukemia and lung cancer occurring in a chronic lymphocytic leukemia patient treated with fludarabine and autologous peripheral blood stem-cell transplantation

An increased incidence of different malignancies associated to chronic lymp hocytic leukemia (CLL) has been reported. The association of CLL and acute leukemia is a rare event described in <1% of CLL, the type of acute leukemi a being either from the lymphoid or more often from the myeloid lineage. Th e coexistence of acute myeloid leukemia (AML) and CLL in the same patient h as been occasionally reported. Most of these cases have been associated wit h the administration of chemotherapy or radioterapy for CLL, suggesting tha t the former may be a secondary leukemia. On the other hand, CLL could prec ede, but could also be diagnosed at the same, or delayed time as AML, sugge sting the presence of other leukemogenic factors. We describe the exception al development of AML and lung cancer in a patient with previously diagnose d CLL in minimal residual disease status after fludarabine treatment follow ed by autologous peripheral blood stem-cell transplantation.