De-Novo B-Cell Prolymphocytic Leukemia

Area of Science:

• Hematology
• Oncology

Background:

• B-cell prolymphocytic leukemia (B-PLL) is a rare B-cell neoplasm.
• Diagnosis requires bone marrow biopsy, flow cytometry, and cytogenetics.

Observation:

• A rare case of B-PLL in a patient with no prior history of chronic lymphocytic leukemia (CLL) is presented.
• The patient presented with splenomegaly and elevated white blood cell count.

Findings:

• B-PLL diagnosis requires at least 55% prolymphocytes in peripheral blood.
• Differential diagnosis includes mantle cell lymphoma, CLL with prolymphocytes, hairy cell leukemia, and splenic marginal zone lymphoma.

Implications:

• B-PLL management often mirrors CLL treatment (e.g., ibrutinib, rituximab), tailored individually.
• Recent WHO classifications do not recognize B-PLL as a distinct entity, prompting discussion on its reclassification based on further research and documentation.