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. 2020 Sep 11;10:540030. doi: 10.3389/fonc.2020.540030

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Copyright © 2020 Simnica, Ittrich, Bockemeyer, Stein and Binder.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Patient with BRAF V600E-mutant hairy cell leukemia (HCL) and concomitant RAS-mutant B cell lymphocytosis (MBL) experiencing progression to chronic lymphocytic leukemia (CLL). (A) Computed tomography scans of cervical lymph nodes of patient with HCL and concomitant MBL/CLL. On the left, nodal progression on dual BRAFi/MEKi. On the right, nodal remission 3 months after BRAFi withdrawal. (B) Absolute MBL/CLL and HCL cell counts over time during combined BRAFi/MEKi and after BRAFi withdrawal. Cell counts were deduced from flow cytometry, IGH next-generation sequencing and KRAS G12D liquid biopsy analyses of peripheral blood. Clone CARSDFWGDAFDIW (green line) represents the MBL/CLL clone and clone CAKDPPLNHFWGGYPFSFDNW (red line) represents HCL clone. IGH, Immune globulin heavy locus. Arrows indicate cervical lymphnode.