迄今为止，很少有同时发生急性髓系白血病（AML）和未经治疗的慢性淋巴细胞白血病（CLL）的病例报道。由于发病机制的复杂性和缺乏统一的治疗方案，相关的预后仍然较差。本研究报告了一名患有无症状白细胞增多症的 58 岁男性病例，他之前身体健康，没有恶性肿瘤。流式细胞术分析显示骨髓标本中存在原核细胞增多、单核细胞增多和单克隆 B 淋巴细胞增多。基因重排测定结果表明单克隆 B 淋巴细胞中免疫球蛋白重链可变区基因状态呈阳性。因此，该患者被诊断为与未经治疗的 CLL 共存的成熟 AML (AML-M2)。标准柔红霉素（第 1-3 天 40 mg/m2）和阿糖胞苷（第 1-7 天 80 mg/m2）方案联合维奈托克（第 1-7 天 400 mg/m2）和利妥昔单抗（第 0 天 375 mg/m2） ）用作诱导化疗。在第一个疗程的化疗后，患者的 AML 和 CLL 均达到形态学完全缓解。此外，本研究回顾性分析了22例并发AML和未经治疗的CLL患者的数据，结果显示，AML诊断时的中位年龄为69岁（范围为52-86岁）。此外，男女比例为 6.33:1，AML-M2 是诊断时最常见的亚型。复杂核型的存在与最差的预后相关，而接受维奈托克治疗的患者通常表现出更好的预后。总之，维奈托克和利妥昔单抗的组合可改善并发 AML 和未经治疗的 CLL 患者的预后。版权所有：© 2024 Chen 等人。

To date, few cases of concurrent acute myeloid leukemia (AML) and untreated chronic lymphocytic leukemia (CLL) have been reported. Due to the complexity of the pathogenesis and the absence of a uniform treatment regimen, the associated prognosis remains poor. The present study reports the case of a 58-year-old male with asymptomatic leukocytosis, who was previously healthy with no malignancies. Flow cytometry analysis revealed protocytosis, monocytosis and monoclonal B lymphocytosis in a bone marrow specimen. Results of a gene rearrangement assay demonstrated positive immunoglobulin heavy-chain variable region gene status in monoclonal B lymphocytes. Thus, the patient was diagnosed with AML with maturation (AML-M2) that co-existed with untreated CLL. The normative daunorubicin (40 mg/m2 on days 1-3) and cytarabine (80 mg/m2 on days 1-7) regimen combined with venetoclax (400 mg on days 1-7) and rituximab (375 mg/m2 on day 0) was used as induction chemotherapy. The patient achieved morphological complete remission in both AML and CLL following the first course of chemotherapy. In addition, the present study retrospectively analyzed the data of 22 patients with concurrent AML and untreated CLL, and the results demonstrated that the median age at the time of AML diagnosis was 69 years (range, 52-86 years). Moreover, the male:female ratio was 6.33:1 and AML-M2 was the most frequent subtype at diagnosis. The presence of a complex karyotype was associated with the poorest prognosis, and patients who received venetoclax often exhibited an improved prognosis. In conclusion, the combination of venetoclax and rituximab improves the prognosis of patients with concurrent AML and untreated CLL.Copyright: © 2024 Chen et al.