Unusual T-Lymphoblastic Blast Phase of Chronic Myelogenous Leukemia

T-lymphoblastic leukemia/lymphoma (T-ALL) presenting as blast phase of chronic myelogenous leukemia (CML-BP) is rare. In patients without history of CML, it is difficult to differentiate between CML-BP or de novo T-ALL. Here we reported 2 unusual cases of T-ALL presenting as CML-BP. Case 1 was a 24-...

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Main Authors: Jie Xu, Shaoying Li
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:Case Reports in Hematology
Online Access:http://dx.doi.org/10.1155/2014/304359
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author Jie Xu
Shaoying Li
author_facet Jie Xu
Shaoying Li
author_sort Jie Xu
collection DOAJ
description T-lymphoblastic leukemia/lymphoma (T-ALL) presenting as blast phase of chronic myelogenous leukemia (CML-BP) is rare. In patients without history of CML, it is difficult to differentiate between CML-BP or de novo T-ALL. Here we reported 2 unusual cases of T-ALL presenting as CML-BP. Case 1 was a 24-year-old female with leukocytosis. Besides T-lymphoblasts (32%), her marrow exhibited some morphologic features of CML. Multiple remission or relapsing marrow had never demonstrated morphologic features of CML. Despite of imatinib treatment and stem cell transplant, she died 2.5 years later. Case 2, a 66-year-old male with diffuse lymphadenopathy, showed T-ALL in a lymph node and concurrent CML chronic phase (CML-CP) in his marrow. Same BCR-ABL1 fusion transcript with minor breakpoint was present in both the lymph node and marrow specimens. Although both cases did not have a history of CML, both cases represented T-lymphoblastic CML-BP with unusual features: Case 1 is unusual in that it presented as T-ALL with some CML morphologic feature but never showed CML-CP in her subsequent marrows biopsies; Case 2 is the first reported case of T-lymphoblastic CML-BP harboring BCR-ABL1 transcript with a minor breakpoint.
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spelling doaj-art-8c92c75193db48a892b33d7fa59d83652025-08-20T02:09:33ZengWileyCase Reports in Hematology2090-65602090-65792014-01-01201410.1155/2014/304359304359Unusual T-Lymphoblastic Blast Phase of Chronic Myelogenous LeukemiaJie Xu0Shaoying Li1Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35294, USADepartment of Pathology, Microbiology, and Immunology, School of Medicine, Vanderbilt University, 4605 TVC, Nashville, TN 37232-5310, USAT-lymphoblastic leukemia/lymphoma (T-ALL) presenting as blast phase of chronic myelogenous leukemia (CML-BP) is rare. In patients without history of CML, it is difficult to differentiate between CML-BP or de novo T-ALL. Here we reported 2 unusual cases of T-ALL presenting as CML-BP. Case 1 was a 24-year-old female with leukocytosis. Besides T-lymphoblasts (32%), her marrow exhibited some morphologic features of CML. Multiple remission or relapsing marrow had never demonstrated morphologic features of CML. Despite of imatinib treatment and stem cell transplant, she died 2.5 years later. Case 2, a 66-year-old male with diffuse lymphadenopathy, showed T-ALL in a lymph node and concurrent CML chronic phase (CML-CP) in his marrow. Same BCR-ABL1 fusion transcript with minor breakpoint was present in both the lymph node and marrow specimens. Although both cases did not have a history of CML, both cases represented T-lymphoblastic CML-BP with unusual features: Case 1 is unusual in that it presented as T-ALL with some CML morphologic feature but never showed CML-CP in her subsequent marrows biopsies; Case 2 is the first reported case of T-lymphoblastic CML-BP harboring BCR-ABL1 transcript with a minor breakpoint.http://dx.doi.org/10.1155/2014/304359
spellingShingle Jie Xu
Shaoying Li
Unusual T-Lymphoblastic Blast Phase of Chronic Myelogenous Leukemia
Case Reports in Hematology
title Unusual T-Lymphoblastic Blast Phase of Chronic Myelogenous Leukemia
title_full Unusual T-Lymphoblastic Blast Phase of Chronic Myelogenous Leukemia
title_fullStr Unusual T-Lymphoblastic Blast Phase of Chronic Myelogenous Leukemia
title_full_unstemmed Unusual T-Lymphoblastic Blast Phase of Chronic Myelogenous Leukemia
title_short Unusual T-Lymphoblastic Blast Phase of Chronic Myelogenous Leukemia
title_sort unusual t lymphoblastic blast phase of chronic myelogenous leukemia
url http://dx.doi.org/10.1155/2014/304359
work_keys_str_mv AT jiexu unusualtlymphoblasticblastphaseofchronicmyelogenousleukemia
AT shaoyingli unusualtlymphoblasticblastphaseofchronicmyelogenousleukemia