{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T09:43:45Z","timestamp":1753868625257,"version":"3.41.2"},"reference-count":8,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,1,24]],"date-time":"2022-01-24T00:00:00Z","timestamp":1642982400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The \u201caccelerated\u201d chronic lymphocytic leukemia (aCLL) is a relatively rare form of CLL progression. The expanded proliferation centers in aCLL have been associated with adverse prognostic features and propensity to more aggressive behavior with shorter survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case<\/jats:title><jats:p>An atypical case of aCLL with distinct features is described. A 66\u2010year\u2010old female presented with a marrow replacing process associated with multiple osseous metastases and trivial lymphadenopathy. Bone biopsy revealed an unspecified low\u2010grade B cell lymphoproliferative disorder that demonstrated a suboptimal response to standard chemotherapy. Subsequent lymph node biopsy demonstrated findings consisted with aCLL. The distinguishing features of the case were, in addition to bone involvement, the lagging peripheral lymphocytosis and a striking pattern of the chromatin clumping with a prominent \u201cshattered\u201d appearance reminiscent of Pelger\u2010Huet\u2010like dysplastic anomaly. A targeted next\u2010generation sequencing (NGS) assay detected pathogenic mutations in <jats:italic>TP53<\/jats:italic> and <jats:italic>SF3B1<\/jats:italic>. In contrast to chemotherapy, the case demonstrated an excellent response to imbruvica.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The noted peculiarities could potentially distinguish this case as a novel, rare variant of aCLL.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cnr2.1601","type":"journal-article","created":{"date-parts":[[2022,1,25]],"date-time":"2022-01-25T06:23:26Z","timestamp":1643091806000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Atypical \u201caccelerated\u201d chronic lymphocytic leukemia with abnormal lymphocyte chromatin clumping, bone involvement, and exceptional response to Imbruvica"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8712-1141","authenticated-orcid":false,"given":"Leonid L.","family":"Yavorkovsky","sequence":"first","affiliation":[{"name":"Oncology Division Kaiser Permanente San Jose Medical Center  San Jose California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,1,24]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-198812000-00002"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2010.022277"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.1988.tb02433.x"},{"issue":"5","key":"e_1_2_8_5_1","first-page":"46","article-title":"A case of marked pseudo\u2010Pelger\u2010Huet anomaly of neutrophils in a patient with myelodysplastic syndrome and partial red cell aplasia (a special type of acute leukemia with pathologic blast differentiation)","volume":"34","author":"Iavorkovski\u012d LL","year":"1989","journal-title":"Gematol Transfuziol"},{"key":"e_1_2_8_6_1","first-page":"247","article-title":"Successful treatment of \u201caccelerated\u201d chronic lymphocytic leukemia with single agent ibrutinib: a report of two cases","volume":"15","author":"Xie J","year":"2021","journal-title":"Leukemia Res Rep"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2018.187583"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2019.229161"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2011.247"}],"container-title":["Cancer Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cnr2.1601","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/cnr2.1601","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cnr2.1601","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T12:21:06Z","timestamp":1692793266000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cnr2.1601"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,24]]},"references-count":8,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2022,9]]}},"alternative-id":["10.1002\/cnr2.1601"],"URL":"https:\/\/doi.org\/10.1002\/cnr2.1601","archive":["Portico"],"relation":{},"ISSN":["2573-8348","2573-8348"],"issn-type":[{"type":"print","value":"2573-8348"},{"type":"electronic","value":"2573-8348"}],"subject":[],"published":{"date-parts":[[2022,1,24]]},"assertion":[{"value":"2021-09-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e1601"}}