An unusual case of T-cell acute lymphoblastic leukemia in a patient with BCR-ABL positive chronic myeloid leukemia and Gaucher disease
© 2021 The Authors..
BACKGROUND: Chronic myelogenous leukemia (CML) is a chronic myeloproliferative disease characterized by a massive overproduction of myeloid cells. It is associated with the Philadelphia chromosome [Ph1, t (9; 22) (q34; q11)] or BCR-ABL fusion gene. CML usually undergoes a triphasic clinical course ending in a blast crisis, an accelerated phase of blasts and promyelocyte production. Ten percent of CML patients reach the blast crisis phase, with 20-30% of leukemias belonging to B-cell lymphoid lineage. However, a transformation of CML into T-cell acute lymphoblastic leukemia (T-ALL) is rare.
CASE PRESENTATION: We present a 56-year-old male patient, known case of hypertension and Ph1 CML of eight years with a family history of Gaucher disease who developed T-ALL. The patient presented with lymphadenopathy and severe anemia, needing packed RBC transfusion, neutropenia and thrombocytopenia at the admission. However, the monocytes and basophils percentage were high. The patient underwent a cervical lymph node core biopsy, and the immunohistochemistry stains showed an invasion of neoplastic cells positive for CD3, CD5, BCL2, CD34, TdT and focally positive for C-Kit and negative for CD20, CD56 and pan-CK. These histopathology features were consistent with T-cell acute lymphoblastic leukemia (T-ALL).
CONCLUSION: Blast crisis remain a challenge in CML management. It's of great importance to do a full proper workup including lymph nodes biopsies. The aim is to reverse blast crisis and restore the chronic phase.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:68 |
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| Enthalten in: |
Annals of medicine and surgery (2012) - 68(2021) vom: 07. Aug., Seite 102565 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Al-Janazreh, Hamdi [VerfasserIn] |
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| Anmerkungen: |
Date Revised 25.04.2022 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1016/j.amsu.2021.102565 |
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| PPN (Katalog-ID): |
NLM328807427 |
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| 100 | 1 | |a Al-Janazreh, Hamdi |e verfasserin |4 aut | |
| 245 | 1 | 3 | |a An unusual case of T-cell acute lymphoblastic leukemia in a patient with BCR-ABL positive chronic myeloid leukemia and Gaucher disease |
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| 500 | |a Date Revised 25.04.2022 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2021 The Authors. | ||
| 520 | |a BACKGROUND: Chronic myelogenous leukemia (CML) is a chronic myeloproliferative disease characterized by a massive overproduction of myeloid cells. It is associated with the Philadelphia chromosome [Ph1, t (9; 22) (q34; q11)] or BCR-ABL fusion gene. CML usually undergoes a triphasic clinical course ending in a blast crisis, an accelerated phase of blasts and promyelocyte production. Ten percent of CML patients reach the blast crisis phase, with 20-30% of leukemias belonging to B-cell lymphoid lineage. However, a transformation of CML into T-cell acute lymphoblastic leukemia (T-ALL) is rare | ||
| 520 | |a CASE PRESENTATION: We present a 56-year-old male patient, known case of hypertension and Ph1 CML of eight years with a family history of Gaucher disease who developed T-ALL. The patient presented with lymphadenopathy and severe anemia, needing packed RBC transfusion, neutropenia and thrombocytopenia at the admission. However, the monocytes and basophils percentage were high. The patient underwent a cervical lymph node core biopsy, and the immunohistochemistry stains showed an invasion of neoplastic cells positive for CD3, CD5, BCL2, CD34, TdT and focally positive for C-Kit and negative for CD20, CD56 and pan-CK. These histopathology features were consistent with T-cell acute lymphoblastic leukemia (T-ALL) | ||
| 520 | |a CONCLUSION: Blast crisis remain a challenge in CML management. It's of great importance to do a full proper workup including lymph nodes biopsies. The aim is to reverse blast crisis and restore the chronic phase | ||
| 650 | 4 | |a Case Reports | |
| 650 | 4 | |a Blast crisis | |
| 650 | 4 | |a CML | |
| 650 | 4 | |a Case report | |
| 650 | 4 | |a T-ALL | |
| 650 | 4 | |a Transformation | |
| 700 | 1 | |a Abuzneid, Yousef S |e verfasserin |4 aut | |
| 700 | 1 | |a Khamayseh, Iman |e verfasserin |4 aut | |
| 700 | 1 | |a Morabito, Fortunato |e verfasserin |4 aut | |
| 700 | 1 | |a Alqam, Bilal |e verfasserin |4 aut | |
| 700 | 1 | |a Abusabbah, Rosaline M F |e verfasserin |4 aut | |
| 700 | 1 | |a Mustafa, Fatima K |e verfasserin |4 aut | |
| 700 | 1 | |a Sarahneh, Shifa |e verfasserin |4 aut | |
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