Megakaryocytic blast crisis as first presentation of chronic myeloid leukemia

Campiotti, Leonardo; Grandi, Anna Maria; Biotti, M.G.; Ultori, Carolina; Solbiati, Francesco; Codari, R.; Venco, Achille

doi:10.1002/ajh.20797

Cited by 9 publications

(6 citation statements)

References 9 publications

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“…Myelofibrosis or increased bone marrow reticulin are a prominent aspect in most AMKL patients. In some cases, megakaryoblastic crisis could be the first presentation of CML, and not distinguishable from de novo AMKL [12-16]. This case represents de novo AMKL in our opinion, because the patient had no basophilia and eosinophilia upon presentation, which are often seen in blast crisis of CML [17].…”

Section: Discussionmentioning

confidence: 89%

“…Cytogenetic analysis of trypsin R-banded chromosome preparations revealed 46, XX, der(16)t(1;16)(q21;q23)[8]/46,XX [12] (Figure 2). To identify fusion genes, multiplex reverse transcription-polymerase chain reaction (RT-PCR) was performed with 1~8 parallel nested (2-round) multiplex reactions in a thermocycler (Perkin-Elmer) to achieve maximal sensitivity, as described in a previous study [11].…”

Section: Case Presentationmentioning

confidence: 99%

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De novo acute megakaryoblastic leukemia with p210 BCR/ABL and t(1;16) translocation but not t(9;22) Ph chromosome

Xiao

Liu

et al. 2011

J Hematol Oncol

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Acute megakaryoblastic leukemia (AMKL) is a type of acute myeloid leukemia (AML), in which majority of the blasts are megakaryoblastic. De novo AMKL in adulthood is rare, and carries very poor prognosis. We here report a 45-year-old woman with de novo AMKL with BCR/ABL rearrangement and der(16)t(1;16)(q21;q23) translocation but negative for t(9;22) Ph chromosome. Upon induction chemotherapy consisting of homoharringtonine, cytarabine and daunorubicin, the patient achieved partial hematological remission. The patient was then switched to imatinib plus one cycle of CAG regimen (low-dose cytarabine and aclarubicin in combination with granulocyte colony-stimulating factor), and achieved complete remission (CR). The disease recurred after 40 days and the patient eventually died of infection. To the best of our knowledge, this is the first report of de novo AMKL with p210 BCR/ABL and der(16)t(1;16)(q21;q23) translocation but not t(9;22) Ph chromosome.

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Section: Discussionmentioning

confidence: 89%

Section: Case Presentationmentioning

confidence: 99%

De novo acute megakaryoblastic leukemia with p210 BCR/ABL and t(1;16) translocation but not t(9;22) Ph chromosome

Xiao

Liu

et al. 2011

J Hematol Oncol

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“…Megakaryocytic blast crisis as the presenting manifestation of CML is rare. Previous studies (11,12,19), with the exception of a study by Westfall et al (20), have shown that imatinib has good effects on patients with a megakaryocytic blast crisis of CML. However, the in vitro effect of exposure to imatinib on the proliferation or apoptosis of CD34 + cells from patients with CML in the megakaryocytic crisis phase has not been described.…”

Section: Discussionmentioning

confidence: 93%

In vitro effects of imatinib on CD34+ cells of patients with chronic myeloid leukemia in the megakaryocytic crisis phase

et al. 2014

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Imatinib is a tailored drug for the treatment of chronic myeloid leukemia (CML), and has substantial activity and a favorable safety profile when used as a single agent in patients with CML in myeloid blast crisis. The megakaryocytic blast crisis in CML occurs rarely and carries a poor prognosis. The aim of the present study was to investigate the effects of imatinib on cluster of differentiation (CD)34+ cells from patients with CML in the megakaryocytic crisis phase. Bone marrow mononuclear cells (BMNCs) were isolated from patients with CML in the megakaryocytic crisis phase. CD34+ cells were selected from BMNCs by positive immunomagnetic column separation. Imatinib significantly induced G1 arrest, reduced the phosphorylation of cyclin-dependent kinase 1 and retinoblastoma proteins and inhibited the proliferation of CD34+ cells from patients with CML in the megakaryocytic crisis phase. Annexin V/propidium iodide and caspase-3 activity showed that imatinib induced apoptosis. Western blot analysis and protein tyrosine kinase activity assays showed that imatinib inhibited BCR-ABL protein tyrosine kinase activity. The in vitro data thus markedly indicate a potential clinical application of imatinib for patients with CML in the megakaryocytic crisis phase.

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“…Rarely, patients with CML can present directly in a blast crisis. While most blast crises are of myeloid origin, myeloid blast crisis with ALL‐like morphologic features and Ph‐positive AML is rare, especially at the time of CML diagnosis . This is the first case of CML blast crisis presented with AML of t(9;22) and t(3;14) double translocation mimicking ALL.…”

Section: Introductionmentioning

confidence: 95%

Chronic myeloid leukemia blast crisis presented with AML of t(9;22) and t(3;14) mimicking acute lymphocytic leukemia

Liu

Wang

et al. 2019

Clinical Laboratory Analysis

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Background Clinically, 90%‐95% of cases of CML have the characteristic t(9;22) (q34.1;q11.2) translocation that leads to the Philadelphia (Ph) chromosome. Rarely, patients with CML can present directly in a blast crisis (BC). While most blast crises are of myeloid origin, myeloid BC with ALL‐like morphologic features and Ph‐positive acute myeloid leukemia (AML) is rare, especially at the time of CML diagnosis. Case presentation A 20‐year‐old man presented with Ph chromosome‐positive AML mimicking acute lymphocytic leukemia (ALL). Bone marrow (BM) aspiration revealed AML with ALL‐like morphologic features. The results of the immunophenotypic analysis suggested AML. Cytogenetic analysis of the BM cells revealed a 46,XY,t(3;14)(q21;q32),t(9;22)(q34;q11.2)[20] karyotype. Thus, we called the condition AML mimicking ALL. The patient was diagnosed with myeloid BC based on the combination of clinical, cytologic, and cytogenetic studies. Conclusion To date, no case reports of a patient diagnosed with CML BC presented with Ph chromosome‐positive AML mimicking ALL have been reported. We present the case given its rarity, easy misdiagnosis, and poor prognosis. It is important to combine clinical, cytologic, and cytogenetic analyses in distinguishing CML BC from de novo AML with the t(9;22)，and further cases should be accumulated to explore how to improve the prognosis of the patients.

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Megakaryocytic blast crisis as first presentation of chronic myeloid leukemia

Cited by 9 publications

References 9 publications

De novo acute megakaryoblastic leukemia with p210 BCR/ABL and t(1;16) translocation but not t(9;22) Ph chromosome

De novo acute megakaryoblastic leukemia with p210 BCR/ABL and t(1;16) translocation but not t(9;22) Ph chromosome

In vitro effects of imatinib on CD34+ cells of patients with chronic myeloid leukemia in the megakaryocytic crisis phase

Chronic myeloid leukemia blast crisis presented with AML of t(9;22) and t(3;14) mimicking acute lymphocytic leukemia

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