# Chronic myelomonocytic leukemia complicated with T-lymphoblastic lymphoma: a case report and literature review

## TL;DR

This paper reports a rare case of a patient with both chronic myelomonocytic leukemia and T-lymphoblastic lymphoma, highlighting the challenges in diagnosis and treatment.

## Contribution

The novelty lies in the detailed clinical and molecular analysis of a rare coexistence of CMML and T-LBL, along with treatment outcomes.

## Key findings

- The patient achieved complete remission of T-LBL with VDCP chemotherapy but later relapsed as T-ALL.
- Combination therapy with venetoclax and CHG induced remission in T-ALL while CMML remained indolent.
- The case underscores the importance of multidisciplinary approaches in managing rare hematologic malignancies.

## Abstract

慢性粒-单核细胞白血病（CMML）与T淋巴母细胞淋巴瘤（T-LBL）均为血液系统恶性肿瘤，二者共存罕见。本文报道1例65岁女性患者，因“枕颈部肿块伴发热、盗汗1个月”就诊，经骨髓穿刺、淋巴结活检、流式细胞术及分子学检测，确诊为CMML-1合并T-LBL。患者在接受VDCP（长春地辛+柔红霉素+环磷酰胺+地塞米松）方案化疗后T-LBL达完全缓解，但后续复发并进展为T淋巴母细胞白血病（T-ALL）。在挽救治疗失败后，采用维奈克拉联合CHG方案诱导治疗，T-ALL再次达完全缓解，而CMML始终处于惰性病程。本文结合文献复习，探讨CMML与T-LBL共存的临床病理特征、分子机制及治疗策略，强调多学科协作与个体化治疗在罕见血液肿瘤中的重要性。