Contributed by Peter Christakos, MD and Lydia Contis, MD
Published on line in March 1998
The patient is a 76 year old white male previously diagnosed with chronic lymphocytic leukemia (CLL) in 1994, initially treated with Fludarabine, and subsequently with ARA-C. Past medical history also includes coronary artery disease and emphysema. He now presents to an outside hospital with increasing dyspnea, a marked leukocytosis (>360,000) and splenomegaly. He was transferred to UPMC for further management. A diagnostic bone marrow biopsy and aspirate were performed.