Abstract
Rare patients with chronic myeloid leukemia (CML) can present initially in lymphoblastic crisis (LBC) mimicking Ph + B-lymphoblastic leukemia (B-ALL). We retrospectively reviewed 275 adults who diagnosed initially as Ph + B-ALL and identified 28 patients with at least one of three features supporting the diagnosis of CML-LBC: 1) a large discrepancy between the blast count and Ph + clone; 2) Ph + clone persistent when B-ALL in remission; 3) BCR/ABL1 fusion detected in segmented cells. BCR-ABL1 fusions were p210 in 25 patients and p190 in 3 patients. In comparison to patients with Ph + B-ALL, patients with CML-LBC were older; had higher leukocyte and absolute neutrophil counts; higher immature myeloid cells in peripheral blood; lower blast counts; and inferior outcomes. In addition, we prospectively analyzed 26 patients with Ph + B-lymphoblastic leukemia and identified 8 patients with features more consistent with CML-LBC. These findings highlight the importance of distinguishing CML-LBC from de novo Ph + B-ALL.
Original language | English (US) |
---|---|
Pages (from-to) | 2831-2838 |
Number of pages | 8 |
Journal | Leukemia and Lymphoma |
DOIs | |
State | Published - 2020 |
Keywords
- B-lymphoblastic leukemia
- Chronic myeloid leukemia
- Philadelphia chromosome
- lymphoblastic crisis
ASJC Scopus subject areas
- Hematology
- Oncology
- Cancer Research