CD5-negative, CD10-negative small B-cell leukemia: variant of chronic lymphocytic leukemia or a distinct entity?

75 yrs female presenting with 3 months duration of anemia, fever ,bony pains and loss of appetite with CBC revealing Hb. 6.6g/dl, TLC 5.0 x 109 /L, DLC N55, L32, and M8. Platelets 094x109 /L. PBF showed scanty number of smudge cells and no roulex formation. Bone marrow aspiration and imprints showed markedly hyper cellular marrow with 80% mature lymphocytes. The Plasma cells were (3.5%). Trephine biopsy also showed hypercellular marrow with infiltration by lymphomononuclear cells. Serum electrophoresis showed M-spike while as markers were negative for CD 5, CD 10, Cyclin D, and Bcl 2 was immunoreactive in all hematopoietic cells. Patient was treated with CVP regimen and went in remission and is currently following with normal clinical examination and normal CBC. We strongly believe that this could be a variant of chronic lymphocytic leukemia with CD 5, CD10 negative markers.