Document Detail

T-cell prolymphocytic leukemia: A rare disease in an elderly female.
MedLine Citation:
PMID:  21129072     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To present a case report of an 83-year-old female with underlying dementia and a 1-2 month history of left upper quadrant pain. This report includes a review of the morphology of T-cell prolymphocytic leukemia (PLL), diagnosis, and the treatment options considered.
DATA SOURCES: T-cell PLL is a rare blood disorder that represents a very small number of all chronic leukemias. An extensive review of scientific literature related to the cell morphology and pathology of this disease, as well as clinical trials of treatment options provided the background for this case report.
CONCLUSION: A diagnosis of T-cell PLL was made after a computed tomography scan of the abdomen confirmed splenomegaly and a bone marrow biopsy showed a hypercellular marrow infiltrated with numerous small lymphocytes, consistent with this disease. Currently, there is no optimal treatment for T-cell PLL, but alemtuzumab has shown success with extending survival 1-3 years.
IMPLICATIONS FOR PRACTICE: This case presented several ethical and practical challenges for this patient and her family in making a decision for chemotherapy treatment. This case underscores the need for the physicians and nurse practitioners to establish a collaborative relationship with patient, family, and other care providers when advocating for or against treatment.
Linda Madaris
Publication Detail:
Type:  Case Reports; Journal Article; Review     Date:  2010-11-05
Journal Detail:
Title:  Journal of the American Academy of Nurse Practitioners     Volume:  22     ISSN:  1745-7599     ISO Abbreviation:  J Am Acad Nurse Pract     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-06     Completed Date:  2011-04-01     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  8916634     Medline TA:  J Am Acad Nurse Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  648-53     Citation Subset:  N    
Copyright Information:
©2010 The Author Journal compilation ©2010 American Academy of Nurse Practitioners.
University of South Florida, Tampa, Florida, USA.
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MeSH Terms
Abdominal Pain / etiology
Aged, 80 and over
Antibodies, Monoclonal / adverse effects,  therapeutic use
Antibodies, Monoclonal, Humanized
Antibodies, Neoplasm / adverse effects,  therapeutic use
Antineoplastic Agents / adverse effects,  therapeutic use
Bone Marrow Examination
Dementia / complications
Fatal Outcome
Leukemia, Prolymphocytic, T-Cell / complications,  diagnosis*,  drug therapy*,  epidemiology
Nurse Practitioners
Patient Selection
Rare Diseases
Tomography, X-Ray Computed
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 0/Antibodies, Neoplasm; 0/Antineoplastic Agents; 3A189DH42V/alemtuzumab

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