Chronic myeloid leukaemia (CML) presenting in B-lymphoblastic crisis: a diagnostic challenge
Tóm tắt
We report the case of a 75-year-old female presented with lethargy, Hb 93 g/L, WBC 64 x 109/L, platelet 110 x 109/L. Blood film showed blasts, myelocytes, metamyelocytes, neutrophils. Quantitative PCR detected p210 BCR::ABL1 transcript in sorted CD19+ cells, and sorted CD19- cells. Bone marrow smear was packed with blasts. Flow cytometry and bone marrow histology revealed B-lymphoblasts. The patient was diagnosed with CML Blymphoblastic crisis. CML presenting in B-lymphoblastic crisis could resemble features of de novo Ph+ B-ALL, which makes the diagnosis challenging. These patients have inferior outcomes; therefore, it is important to distinguishing CML B -lymphoblastic crisis from de novo Ph+ B-ALL. Positive BCR::ABL1 in both CD19+ and CD19- sorted cell populations support the diagnosis of CML B-lymphoblastic crisis in this case.
Tài liệu tham khảo
citation_journal_title=Leukemia; citation_title=The EUTOS population-based registry: incidence and clinical characteristics of 2904 CML patients in 20 European Countries; citation_author=VS Hoffmann, M Baccarani, J Hasford, D Lindoerfer, S Burgstaller, D Sertic, P Costeas, J Mayer, K Indrak, H Everaus; citation_volume=29; citation_publication_date=2015; citation_pages=1336-1343; citation_doi=10.1038/leu.2015.73; citation_id=CR1
citation_journal_title=Blood; citation_title=The 2016 revision of the World Health Organization classification of lymphoid neoplasms; citation_author=SH Swerdlow, E Campo, SA Pileri, NL Harris, H Stein, R Siebert, R Advani, M Ghielmini, GA Salles, AD Zelenetz; citation_volume=127; citation_publication_date=2016; citation_pages=2375-2390; citation_doi=10.1182/blood-2016-01-643569; citation_id=CR2