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A 60 year-old man in the chronic phase of chronic myeloid leukemia (CML-CP) was treated with imatinib mesylate for 1 year. After one year of the initial diagnosis of CML chronic phase, the patient progressed to a promyelocytic blast crisis, karyotyping showed 46,XY,t (9;22)(q34;q11.2), t(15;17)(q22;q21) in all cells examined. The patient was diagnosed with promyelocytic blast crisis of CML. With administration of all-trans retinoic acid (ATRA) and high-dose imatinib mesylate (800 mg/day), the patient has died of disseminated intravascular coagulation within 2 weeks. As karyotyping showed 46,XY,t(9;22)(q34;q11.2), t(15;17) (q22;q21) in all cells examined, this is suggesting that the clonal evolution of PML/RARa translocation occurred early in the CML-CP.

Promyelocytic blast crisis of chronic myeloid leukemia after one year of Imatinib treatment