A case of T-cell chronic lymphocytic leukemia progressing to Richter syndrome with central nervous system involvement in a dog

Conway, E. A. , Waugh, E. M. and Knottenbelt, C. (2020) A case of T-cell chronic lymphocytic leukemia progressing to Richter syndrome with central nervous system involvement in a dog. Veterinary Clinical Pathology, 49(1), pp. 147-152. (doi: 10.1111/vcp.12839) (PMID:32215932)

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Abstract

An 8‐year‐old neutered Beagle dog was presented with polyuria and polydipsia. Routine clinicopathologic testing showed a significant lymphocytosis and proteinuria. Lymphocytes were of small to intermediate in size with a mature morphology. Infectious disease screening was negative. PCR for antigen receptor gene rearrangements showed a clonal T‐cell receptor (TCR) rearrangement consistent with T‐cell chronic lymphocytic leukemia (CLL). Bone marrow cytology showed <30% lymphocytes, while the proportion in splenic fine‐needle aspirate cytology was considered increased. The dog was initially monitored but started on prednisolone and chlorambucil therapy 2 months later due to worsening clinical signs and progressive lymphocytosis. After an additional 2 weeks, the dog developed multifocal spinal pain and single‐node lymphadenomegaly. Cytology of the lymph node showed a monomorphic population of large lymphoblasts consistent with lymphoma. Cytology of a cerebrospinal fluid sample also showed large lymphoblasts. PCR for antigen receptor gene rearrangement at both sites showed a clonal TCR rearrangement of the same molecular size as in the initial leukemic cells. The dog was diagnosed with a transformation of the CLL to Richter syndrome (RS) with involvement of the central nervous system (CNS). Therapy was started with L‐asparaginase and an increased dose of prednisolone; however, the dog was euthanized due to progressive clinical signs. To our knowledge, this is the first report of canine RS with direct involvement of the CNS.

Item Type:Articles
Keywords:General Veterinary
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Conway, Miss Elizabeth and Knottenbelt, Professor Clare and Waugh, Ms Elspeth
Authors: Conway, E. A., Waugh, E. M., and Knottenbelt, C.
College/School:College of Medical Veterinary and Life Sciences > School of Veterinary Medicine
Journal Name:Veterinary Clinical Pathology
Publisher:Wiley
ISSN:0275-6382
ISSN (Online):1939-165X
Published Online:25 March 2020
Copyright Holders:Copyright © 2020 American Society for Veterinary Clinical Pathology
First Published:First published in Veterinary Clinical Pathology 49(1):147-152
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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