Chronic lymphocytic leukemia associated with genetic susceptibility and occupational glyphosate exposure: a case...

Chronic lymphocytic leukemia (CLL) is the most common adult leukemia in Western countries, typically diagnosed in older adults, with a median age of 72. Despite its prevalence, the etiology is unclear, and cases at younger ages have been increasingly reported. We present a case of a male diagnosed in his mid-sixties with CLL to underscore the need for further investigation into the poorly understood etiology and management of CLL. The patient presented to his primary care provider for an annual examination, where an elevated white blood cell (WBC) count was first detected. Over the following two years, persistently elevated WBC counts were noted. Based on a peripheral blood smear and flow cytometry, oncology confirmed the diagnosis of CLL. At present, the patient is categorized at Rai Stage 1. Primary management is active surveillance, reflecting the current therapeutic uncertainty in early-stage disease. In this case, the history revealed prolonged occupational exposure to glyphosate-based (Roundup^®). The patient also had a family history of CLL in his father, who had been exposed to Agent Orange. Although no causal relationship can be inferred from a single case, the co-occurrence of a family history of CLL and occupational glyphosate exposure raises the possibility that multiple risk factors may be relevant to disease development. This case highlights the need for further research into the genetic and environmental factors associated with CLL pathogenesis.