A Rare Case of B-cell Prolymphocytic Leukemia: The First Documented Diagnosis in Georgia With a Comprehensive Literature Review.

Journal: Cureus
Published:
Abstract

B-cell prolymphocytic leukemia (B-PLL) is a rare and aggressive malignancy of mature B-cells associated with poor prognosis, limited treatment options, and a median survival of approximately three years. We report the first documented case of B-PLL in the country of Georgia, involving a 64-year-old male presenting with fever, night sweats, weight loss, and generalized lymphadenopathy. Initial investigations revealed significant lymphocytosis and a predominance of prolymphocytes on the peripheral smear. The diagnosis was confirmed through bone marrow aspirate analysis and flow cytometry, demonstrating clonal B-cell proliferation with a characteristic immunophenotype. The patient was treated with a rituximab-bendamustine (R-B) regimen, achieving complete remission with no detectable minimal residual disease. Remarkably, he remains in clinical remission two years post-diagnosis, underscoring the potential of early and precise diagnosis combined with individualized therapeutic strategies in managing B-PLL. This case highlights the importance of further research to optimize treatment approaches and improve outcomes in this rare and challenging disease.

Authors
Giorgi Maisuradze, Giorgi Akhvlediani, Elene Dzodzuashvili, Tamar Gersamia, Maia Sturua