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Very early onset of an acute myeloid leukemia in an adult patient with B‐cell lymphoblastic leukemia
Author(s) -
SHIVAROV V.,
STOIMENOV A.,
GALABOVA I.,
BALATZENKO G.,
GUENOVA M.
Publication year - 2009
Publication title -
international journal of laboratory hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.705
H-Index - 55
eISSN - 1751-553X
pISSN - 1751-5521
DOI - 10.1111/j.1751-553x.2007.00968.x
Subject(s) - cd33 , immunophenotyping , cd20 , cd117 , cd15 , myeloid , leukemia , bone marrow , myeloid leukemia , medicine , immunology , cancer research , acute leukemia , gene rearrangement , biology , cd34 , gene , genetics , lymphoma , antigen , stem cell
Summary We report on a case of a 30‐year‐old male with acute B‐lymphoblastic leukemia (B‐ALL) with immunophenotype CD19 + , CD22 + , CD20 + , CD10 + , with aberrant expression of CD13 and CD117, and IgH gene rearrangements. Three months after treatment with GMALL‐2003 and Ida/FLAG protocols bone marrow showed predominance of blasts with myeloid morphology and phenotype MPO + , CD13 + , CD33 + , CD64 + , CD15 + , CD56 + , EVI‐1 gene overexpression and lack of IgH rearrangements. The case is the first report of a very early emergence of myeloid leukemia during the induction treatment for B‐ALL in an adult patient. Different pathogenetic mechanisms are discussed – clonal evolution or selection, lineage switch or development of a de novo or therapy‐induced leukemia.