Chronic myeloid leukemia blast crisis presented with AML of t(9;22) and t(3;14) mimicking acute lymphocytic leukemia.
Adult
Blast Crisis
/ diagnosis
Chromosomes, Human, Pair 14
/ genetics
Chromosomes, Human, Pair 22
/ genetics
Chromosomes, Human, Pair 3
/ genetics
Chromosomes, Human, Pair 9
/ genetics
Diagnosis, Differential
Humans
Immunophenotyping
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
/ diagnosis
Leukemia, Myeloid, Acute
/ diagnosis
Male
Philadelphia Chromosome
Precursor Cell Lymphoblastic Leukemia-Lymphoma
/ diagnosis
Prognosis
Translocation, Genetic
Young Adult
blast crisis
chronic myeloid leukemia
cytogenetic analysis
cytologic analysis
Journal
Journal of clinical laboratory analysis
ISSN: 1098-2825
Titre abrégé: J Clin Lab Anal
Pays: United States
ID NLM: 8801384
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
received:
17
05
2019
revised:
02
06
2019
accepted:
03
06
2019
pubmed:
21
6
2019
medline:
13
3
2020
entrez:
21
6
2019
Statut:
ppublish
Résumé
Clinically, 90%-95% of cases of CML have the characteristic t(9;22) (q34.1;q11.2) translocation that leads to the Philadelphia (Ph) chromosome. Rarely, patients with CML can present directly in a blast crisis (BC). While most blast crises are of myeloid origin, myeloid BC with ALL-like morphologic features and Ph-positive acute myeloid leukemia (AML) is rare, especially at the time of CML diagnosis. A 20-year-old man presented with Ph chromosome-positive AML mimicking acute lymphocytic leukemia (ALL). Bone marrow (BM) aspiration revealed AML with ALL-like morphologic features. The results of the immunophenotypic analysis suggested AML. Cytogenetic analysis of the BM cells revealed a 46,XY,t(3;14)(q21;q32),t(9;22)(q34;q11.2)[20] karyotype. Thus, we called the condition AML mimicking ALL. The patient was diagnosed with myeloid BC based on the combination of clinical, cytologic, and cytogenetic studies. To date, no case reports of a patient diagnosed with CML BC presented with Ph chromosome-positive AML mimicking ALL have been reported. We present the case given its rarity, easy misdiagnosis, and poor prognosis. It is important to combine clinical, cytologic, and cytogenetic analyses in distinguishing CML BC from de novo AML with the t(9;22)，and further cases should be accumulated to explore how to improve the prognosis of the patients.
Sections du résumé
BACKGROUND
BACKGROUND
Clinically, 90%-95% of cases of CML have the characteristic t(9;22) (q34.1;q11.2) translocation that leads to the Philadelphia (Ph) chromosome. Rarely, patients with CML can present directly in a blast crisis (BC). While most blast crises are of myeloid origin, myeloid BC with ALL-like morphologic features and Ph-positive acute myeloid leukemia (AML) is rare, especially at the time of CML diagnosis.
CASE PRESENTATION
METHODS
A 20-year-old man presented with Ph chromosome-positive AML mimicking acute lymphocytic leukemia (ALL). Bone marrow (BM) aspiration revealed AML with ALL-like morphologic features. The results of the immunophenotypic analysis suggested AML. Cytogenetic analysis of the BM cells revealed a 46,XY,t(3;14)(q21;q32),t(9;22)(q34;q11.2)[20] karyotype. Thus, we called the condition AML mimicking ALL. The patient was diagnosed with myeloid BC based on the combination of clinical, cytologic, and cytogenetic studies.
CONCLUSION
CONCLUSIONS
To date, no case reports of a patient diagnosed with CML BC presented with Ph chromosome-positive AML mimicking ALL have been reported. We present the case given its rarity, easy misdiagnosis, and poor prognosis. It is important to combine clinical, cytologic, and cytogenetic analyses in distinguishing CML BC from de novo AML with the t(9;22)，and further cases should be accumulated to explore how to improve the prognosis of the patients.
Identifiants
pubmed: 31218758
doi: 10.1002/jcla.22961
pmc: PMC6805270
doi:
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
e22961Informations de copyright
© 2019 The Authors. Journal of Clinical Laboratory Analysis Published by Wiley Periodicals, Inc.
Références
J Pediatr Hematol Oncol. 2002 Nov;24(8):670-1
pubmed: 12439042
J Cell Physiol. 2019 Jul;234(7):11092-11102
pubmed: 30478893
Leuk Lymphoma. 2017 Mar;58(3):708-710
pubmed: 27379703
Br J Haematol. 1991 Jul;78(3):325-9
pubmed: 1651754
J Cell Physiol. 2019 May;234(5):5798-5806
pubmed: 30430567
Am J Hematol. 2007 Mar;82(3):231-3
pubmed: 17022045
Cancer. 1987 Sep 1;60(5):974-9
pubmed: 3475159
Leuk Res. 2006 Feb;30(2):225-32
pubmed: 16076492
Oncol Rev. 2015 Mar 09;9(1):261
pubmed: 26779308
J Clin Lab Anal. 2019 Oct;33(8):e22961
pubmed: 31218758
Blood. 2012 Jul 26;120(4):737-47
pubmed: 22653972