Pseudo-Chediak-Higashi Anomaly in Acute Leukemia: A Significant Morphologic Corollary?

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Abstract
Aberrations in leukemic cells similar to the Pelger-Huet anomaly and the May-Hegglin anomaly have been described, but generally leukemic morphologic variations are individually bizarre. We report for the first time two patients with acute myelomonocytic leukemia in whose leukemic cell line morphologic abnormalities closely mimicked the Chediak-Higashi anomaly. Of our leukemic patient, one died after 6 weeks, with evidence of uncontrolled infection in lungs and urinary tract, and probable septicemia. The second patient attained complete hematologic remission with chemotherapy, but not before two separate episodes of septicemia, due to Klebsiella species and Pseudomonas aeruginosa. The leukocyte anomaly disappeared after remission was attained. It is suggested that the lysosomal abnormality known to result in poor granulocyte function in the inherited disorder also does so in the acquired state, pseudo-Chediak-Higashi anomaly associated with leukemia.

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