The literature describing cases of chronic lymphocytic leukemia complicated by reactions to vaccination is sparse. A case is presented to describe this complication and to discuss its possible pathogenesis.
This 72-year-old white man was in good health until 1950 when the diagnosis of chronic lymphocytic leukemia was made. Except for several blood transfusions in 1956, he had received no therapy. At that time he also developed an exfoliative dermatitis which responded well to steroids. His family history and past history were essentially negative, with the exception of a 30-pound weight loss in the year preceding admission. In May, 1958, he was vaccinated in the left deltoid region as treatment for a probable recurrent herpes simplex of the mouth. He stated that this was his first smallpox vaccination. Two days later his shoulder became swollen, painful, and indurated, but there was no systemic reaction. Five weeks later the area became