We present the case of a 46-year-old male patient who came to our emergency department in December 2019 for pain in the left abdominal quadrant. The patient had no fever, night sweats or a history of weight loss. The laboratory tests revealed important leucocytosis and the abdominal ultrasound highlighted a massive splenomegaly. He was hospitalized for further investigations. We performed all the necessary laboratory tests to establish the diagnosis of the patient. Even though the osteomedullar biopsy and the flow cytometry suggested the diagnosis of acute B-cell lymphoblastic leukemia, the fluorescence in situ hybridization exam – the translocation t(9;22) was present in 100% of the analyzed cells – and the detection of BCR-ABL1 b2a2 transcript established the diagnosis of chronic myeloid leukemia, B-cell lymphoblastic crisis. We decided to start the treatment with the GRAAPH 2005 protocol associated with imatinib, and the patient was a candidate for allogeneic transplantation. We chose to present this case because the patient was young, without significant comorbidities, with chronic myeloid leukemia – B-cell lymphoblastic crisis as the initial diagnosis, whose evolution was negative, despite his favorable prognosis.
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