Simultaneous and sequential concurrent myeloproliferative and lymphoproliferative neoplasms.

Area of Science:

• Hematology
• Oncology
• Cancer Biology

Background:

• Concurrent myeloid and lymphoid/plasmacytoid neoplasms in a single patient are infrequent, occurring in less than 1% of cases.
• Previous research lacked systematic analysis of common combinations and clonal relationships in these dual diagnoses.

Purpose of the Study:

• To characterize combinations of concurrent myeloid and lymphoid/plasmacytoid neoplasms.
• To determine if these co-occurring neoplasms are clonally related or independent.

Main Methods:

• Analysis of a series of 65 cases from the authors' archive and 185 reported cases.
• Quantification of JAK2(V617F) and KIT(D816V) alleles in bone marrow cells.
• Fluorescence in situ hybridization (FISH) analysis on a subset of cases.

Main Results:

• The most frequent combination observed was Philadelphia chromosome-negative myeloproliferative neoplasm with concurrent B cell chronic lymphocytic leukemia, comprising about 50% of dual-neoplasm cases.
• Analysis of allele quantities and FISH data provided evidence for two independent chronic-stage myeloid and lymphoid/plasmacytoid neoplasms.

Conclusions:

• Concurrent myeloid and lymphoid/plasmacytoid neoplasms are typically independent diseases.
• The combination of myeloproliferative neoplasm and chronic lymphocytic leukemia is the most common co-occurrence.