Increased Incidence of T-Cell Malignancies in Patients with Chronic Lymphocytic Leukemia

We present a patient with chemotherapy-refractory Chronic Lymphocytic Leukemia (CLL) in whom postmortem examination showed hepatosplenomegaly, with both multiple small-cellular CLL lesions and large-cellular, monoclonal T-cell infiltrates. Following this case, the co-incidence of T-cell malignancies and CLL was studied using Dutch and American cancer registry databases. Analysis showed an excess risk for T-cell malignancies in CLL patients, with increased standardized incidence ratios compared with the general population and all cancer survivors in the databases. We hypothesize that CLL cells interact with T-cells in the microenvironment, facilitating malignant transformation.