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Secondary malignancy: a case study

Healthcare Science Section Lead Michelle Bolam presents a case study in which a patient with chronic lymphocytic leukaemia was later diagnosed with chronic myeloid leukaemia.

Routine monitoring bloods were received into the laboratory from Haematology Outpatients on a 73-year-old female with a clinical history of a chronic lymphocytic leukaemia (CLL), diagnosis in 1999. The patient underwent chemotherapy for this in 2019 in the form of chorambucil and obinutuzumab to control the CLL, which was in remission.

When comparing the patient’s full blood count (FBC) on this occasion to their previous sample four months prior there was a marked difference (results shown in Table 1). The patient now appeared to have a leucocytosis and a thrombocytosis, which did not match with the patient’s clinical history of CLL. A peripheral blood film was made in order to investigate the many abnormal parameters to ensure the analyser was giving accurate results.

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Image credit | Shutterstock

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