We present the case of a patient diagnosed in SUUB Hematology with adult T-cell leukemia- lymphoma. The particularities of this case are the delay in diagnosis, the apparent onset of disease with severe eye and skin determination in the leukemic phase, and the particular lung involvement in the fi nal stage of the disease.

Abstract Myelodysplastic syndromes (MDS) are a heterogeneous group of clonal hematopoietic stem cell disorders; they are characterized by ineffective hematopoiesis and a predilection to the development of acute myeloid leukemia (AML). For a rapid evaluation of the outcome in myelodysplastic patients non-cytogenetic prognostic scores can be used. Aim: This study proposed to demonstrate that age and gender are important factors in the outcome of the patients diagnosed with myelodysplastic syndrome. Materials and methods: This study was conducted in the Department of Hematology of the Emergency University Hospital Bucharest during October 2008 and October 2012. Results: Male sex and age higher than 60 years are associated with high risk in the studied cases by using the Spanish prognostic score. According to Goasguen score: male sex and age, patients older than 60 years, present characteristics associated with an intermediate risk. Based on the Dusseldorf score, age over 60 years and female gender were associated with pronounced risk in the examined group. By examining the Bournemouth score in our group, we found that age > 60 years correlated with a higher frequency of risk, but no significant differences regarding the sex of patients were observed. Conclusions: We concluded that age > 60 years and male gender are important predisposing factors in the survival. Abbreviations MDS = myelodysplastic syndromes, AML = acute myeloid leukemia, LDH = lactate dehydrogenase, FAB = French-American-British, WHO = World Health Organization, IPSS = International Prognostic Scoring System, ALIP = abnormal localization of immature precursors, WPSS = WHO classification-based prognostic scoring system, FISH = fluorescence in situ hybridization, del = deletion.

CLL patients are more exposed to develop a second neoplasm, but the association. CLL-MDS is an unusual one. We present the case of a 61-year-old male patient, diagnosed with chronic lymphocytic leukemia in 2007, who developed myelodysplastic features three years later and then acute myeloid leukemia. At diagnosis, the blood tests showed leucocytosis, with lymphocytosis in the peripheral blood and bone marrow. Due to the negative prognostic factors, the patient received treatment with an alkylating agent (FC protocol) and then with alemtuzumab. Three years after being diagnosed with CLL, the patient presented with malaise, recent faintness and fever, with severe anemia and thrombocytopenia. The results from the bone marrow aspirate and biopsy established a new diagnosis: myelodysplastic syndrome. The patient’s general condition was rapidly deteriorating and just two months later, he evolved into acute myeloid leukemia, subtype 6, a very rare type of AML. Soon after, neurological alterations led to cerebral hemorrhage and death. A review of literature is also presented.