Combined immunodeficiency preceding chronic lymphocytic leukemia.

A 66-year-old female, suffering from recurrent infections of the respiratory tract, developed a severe hypogammaglobulinemia and an impaired cell mediated immunity in combination with abdominal lymphadenopathy and splenomegaly. Considering a lymphoid malignancy, an explorative laparotomy was performed. No malignancy could be established. After a follow-up of 2 years a diagnosis of chronic lymphocytic leukemia could be made. The onset of hypogammaglobulinemia 2 years before the development of chronic lymphocytic leukemia is not yet reported in the literature.