T-cell Prolymphocytic leukemia (T-PLL) is a rare post-thymic T-cell malignancy 
that follows an aggressive clinical course. The classical presentation includes 
an elevated white blood cell (WBC) count with anemia and thrombocytopenia, 
hepatosplenomegaly, and lymphadenopathy. T-PLL is a disease of the elderly and 
to our knowledge it has never been described in the pediatric age group. We 
report a case of T-PLL in a 9 year old male who was initially diagnosed with 
T-cell acute lymphoblastic lymphoma (ALL), the diagnosis was later refined to 
T-PLL following additional analysis of bone marrow morphology and 
immunophenotype. Two unusual findings in our patient included CD117 expression 
and an isolated chromosomal 12(p13) deletion. The patient failed to respond to 
standard ALL induction chemotherapy, but achieved complete remission following 
treatment with a fludarabine and alemtuzumab-based regimen.