-: Chronic Lymphoid Leukemia(CLL) in Dog :-
1) Case History
German Shepherd Dog, Sex: Male, Age: 3.5 years.
2) Hematological Findings
Hb: 6.0, Total Leucocyte Count: 2,36,000/micro liter.
3) Biochemical Findings
SGOT: 50 IU/L, SGPT: 12.0 IU/L, Albumin: 1.5 g/dL, ALKP(Alkaline Phosphatase): 474 IU/L*, BUN: 39.2 mg/dL*, Creatinine: 1.8 mg/dL, Glucose: 129 mg/dL.
4) Clinicopathological Findings
Fig.1:Note the presence of numerous well differentiated/matured lymphocytes in a peripheral blood smear from affected dog. These lymphocytes are small in size (smaller than neutrophils) and their nucleus contains dense, clumped chromatin and a very small amount of cytoplasm. Also notice the spherocytic agglutination of erythrocytes. | Fig.2:Note the presence of numerous well differentiated lymphocytes, granulocytopenia, thrombocytopenia, hypochromic anemia with regenerative response and spherocytic agglutination of erythrocytes. |
Fig.3: Peripheral blood smear from a affected dog showing presence of numerous well differentiated lymphocytes, granulocytopenia, thrombocytopenia, hypochromic anemia with regenerative response (polychomasia) and spherocytic agglutination of erythrocytes. | Fig.4: Peripheral blood smear from a affected dog showing presence of numerous well differentiated lymphocytes, granulocytopenia, thrombocytopenia, hypochromic anemia with regenerative response (polychomasia) and spherocytic agglutination of erythrocytes. |
5) Case Discussion
The clinical examination of dog not showed any appreciable evidence of lymphadenopathy. The biochemical parameters SGPT and SGOT are within normal range, depicts no significant hepatic involvement/damage. The striking increase in level of Alkaline Phosphatase & BUN indicates possible involvement of bone marrow and kidney respectively. The results of clinical examination and biochemical findings excludes the possibility of lymphoma. The hematological findings (granulocytopenia, thrombocytopenia and high level of serum alkaline phosphatase) indicates the possible origin of neoplastic cells is bone marrow. The high total leucocyte count and morphology of neoplastic cells in peripheral blood smear supports the diagnosis for chronic lymphoid leukemia (CLL).
In present case, the hematological finding of mild regenerative anemia is somewhat contrasting (when bone marrow involved in lymphoproliferative disease/myelophthisis) but it coincides with some earlier studies on lymphoid leukemia in canines reporting regenerative anemia instead of normocytic normochromic non-regenerative anemia(myelophthisic anemia).
The presence of spherocytic agglutination in peripheral blood smear possibly suggesting the hyperglobulinemia (monoclonal gammopathy/Hyperviscosity Syndrome) associated with increased level of IgM in cases of CLL. The hyperviscosity syndrome reported to cause hemostatic disorders, congestive heart failure or renal failure.