[Preleukemia].

Abstract

Case reports dealing with preleukemic syndromes are rare. During the last years preleukemia has been ill defined. Nowadays, most authors agree that a marrow stem disorder with clinically recognisable haematological abnormalities, which proceed the development of overt leukemia, is to be regarded as preleukemia syndrome. Clinical and haematological features are different in preleukemic syndromes terminating with acute lymphoblastic (ALL) and acute non-lymphoblastic leukemia (ANLL). We describe two cases of preleukemia--the first evolving into ALL and the second into ANLL. Our first patient had developed pancytopenia and hypocellular bone marrow five months before overt ALL. In the moment the diagnosis was made clinical examination revealed enlarged lymph glands, liver and spleen. Laboratory tests showed pancytopenia and bone marrow infiltrated with blasts L1 morphology (F. A. B. classification). Preleukemic phase terminating with ANLL featured pancytopenia and hypercellular bone marrow infiltrated with histiocytes, some showing signs of erythrocyte-, leukocyte- and platelet-ingestion. Diagnosis of acute monoblastic leukemia M5 (F. A. B.) was made three months after the illness onset, according to bone marrow infiltration with monoblasts. Clinical and haematological features helpful in the recognition of preleukemic syndromes are discussed.