B-cell Acute Lymphoblastic Leukemia With t(9;22)(q34;q11) Translocation and Clonal Divergence Through ider(22) Chromosome and t(13;17)(q14;q25) Translocation

B-Lymphoblastic Leukemia Presenting with an Isoderivative Philadelphia Chromosome—A Rare Case Report and Review of Literature

“…[9][10][11][12] However, the isochromosome of the long arm of derivative chromosome 22 from t (9;22) with a deletion of 22p, ider(22)(q10)t(9;22) is very rare. To the best of our knowledge, this is the third case of ider (22) in B-ALL; the first case was reported by Yamamoto et al and the second case was of an adult woman with ider(22) with Phþ B-ALL was reported by Meza-Espinoza et al 13,14 Yamamoto et al 13 reported the first case of ider(22) chromosome in acute leukemia similar to this case. U-type sister chromatid exchange is the probable hypothesis behind ider(22) chromosome formation.…”

“…This is the third instance of ider( 22) in pediatric B-cell acute lymphoblastic leukemia (B-ALL). Bone marrow chromosome analysis by G-banding showed 46,XX,t(9;22) (q34;q11.2)[6]/46,XX,ider(22)(q10)t(9;22)(q34;q11.2) [14]. Fluorescence in situ hybridization (FISH) analysis for BCR::ABL1 fusion showed 40% of interphase cells with two and 35% with three fusion signals that were in concordance with the karyotype.…”