Lymphoblastic leukemic transformation (lymphoblastic crisis) in myelofibrosis and myeloid metaplasia

Polliack, Aaron; Prokocimer, Miron; Matzner, Yaacov

doi:10.1002/ajh.2830090209

Cited by 45 publications

(18 citation statements)

References 37 publications

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“…The transformed leukemic cells often bear a myeloid phenotype with expression of myelomonocytic, megakaryocytic and, rarely, erythroid markers [1,7 -11]. Although rare, transformation to lymphoid malignancy has also been described in five CIMF patients, two with lymphoblastic leukemia [14], one low-grade non-Hodgkin's B-cell lymphoma [12] and two diffuse large cell lymphomas [13]. Furthermore, rare examples of transformation to mixed lineage leukemia in CIMF have been described [9].…”

Section: Discussionmentioning

confidence: 98%

Chronic idiopathic myelofibrosis terminating in extramedullary anaplastic plasmacytoma

Liu

Kallakury

Kessler

et al. 2006

Leukemia & Lymphoma

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Chronic idiopathic myelofibrosis (CIMF) is a chronic myeloproliferative disorder (CMPD) with progressive fibrosis and extramedullary hematopoiesis. Similar to other CMPDs, the stem cell in CIMF has the potential to differentiate into myeloid or lymphoid lineages, and thus CIMF can culminate in acute leukemia of myeloid or, rarely, lymphoid lineage. We describe an unusual case of CIMF terminating in extramedullary anaplastic plasmacytoma. The patient was a 61-year-old male with an 11-year history of CIMF. His course was complicated by rapidly growing abdominal and inguinal lymphadenopathy. Lymph node biopsy revealed a diffuse undifferentiated infiltrate in the background of extramedullary hematopoiesis. Flow cytometric and immunohistochemical analysis demonstrated plasma cell-related antigens (CD138, CD38, cytoplasmic kappa light chain), epithelial membrane antigen and CD43 in the tumor cells. The myeloid, B-cell or T-cell markers were negative. A clonal immunoglobulin heavy chain gene rearrangement was identified by polymerase chain reaction. The plasma cell origin was further confirmed by electron microscopic examination, which revealed stacks of rough endoplasmic reticulum. Monoclonal gammopathy may occur in CIMF, and rare cases of simultaneous plasma cell myeloma and CIMF have been reported in the literature. However, to the best of our knowledge, this is the first report of CIMF terminating in extramedullary anaplastic plasmacytoma.

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Section: Discussionmentioning

confidence: 98%

Chronic idiopathic myelofibrosis terminating in extramedullary anaplastic plasmacytoma

Liu

Kallakury

Kessler

et al. 2006

Leukemia & Lymphoma

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“…MF is the main cause of extramedullary hematopoiesis; it may also be the natural course of PV, and is also called post-polycythemic MF (post-PV PMF). So far, two cases of ALL after the development of post-PV PMF have been reported [23,24]. In one case, the patient had PV for 17 years before MF was diagnosed, and developed ALL a year after MF.…”

Section: Discussionmentioning

confidence: 99%

Acute Lymphoblastic Leukemia in the Course of Polycythemia Vera: A Case Report and Review of Literature

Shen

et al. 2015

Indian J Hematol Blood Transfus

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Introduction Polycythemia vera (PV) is one of the most common forms of myeloproliferative neoplasms. Acute myeloid leukemia secondary to PV is well reported, and the mechanism has been clarified to some extent. Only a limited number of cases have been reported about the development of acute lymphoblastic leukemia (ALL) in the course of PV, and the possible underlying mechanism has not been explored well. Case presentation A 75-year-old patient who developed ALL 3 years after he was diagnosed with PV. The presence of remarkable splenomegaly, typical immunophenotyping of the peripheral blood and increased expression of serum fibrosis markers indicated the existence of extramedullary hematopoiesis which may ascribe to myelofibrosis. After the treatment of dosage-modulated chemotherapy, the patient got complete remission. Conclusion The JAK2 mutation may the underlying factor that contributes to the development of ALL, and the existence of MF may indicate the progression to postpolycythemic MF, which may be a risk factor for the accelerated transformation.

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“…Blastic transformation with lym phoid characteristics is a common occurrence in the terminal phase of chronic myeloid leukemia, and the development of lymphoblastic leukemia in the course of agnogenic myeloid metaplasia has been described in several recent publications [4,6]. The morphologic features of the lymph node biopsy performed in our first patient I year after diagnosis were typical of malignant lymphoma of the diffuse mixed type with complete effacement of lymph node architecture, and in our second patient they were characteristic of dif fuse well-differentiated lymphocytic lymphoma.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, in agnogenic myeloid metaplasia such an evolution is relatively unusual. We found only a few previous descriptions of agnogenic myeloid metaplasia terminating in acute lymphoblastic crisis [4][5][6] and one description of ma lignant lymphoma developing in a patient with ag nogenic myeloid metaplasia [7]. In the following we wish to describe 2 young Arab patients in whom malignant lymphoma developed 1 year after or simul taneous with the diagnosis of agnogenic myeloid metaplasia.…”

Section: Introductionmentioning

confidence: 98%

Evolution of Malignant Lymphoma in Agnogenic Myeloid Metaplasia

Yinnon

Kopolovic²,

Dollberg³

et al. 1988

Oncology

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Two young arab patients are described in whom malignant lymphoma developed within less than 1 year of the diagnosis of agnogenic myeloid metaplasia. Both patients showed a satisfactory response to combined chemotherapy. One of them died of hepatitis B at 10 months and the other is alive and in clinical remission 25 months after initial diagnosis. These observations demonstrate the close relation between myeloproliferative and lymphoproliferative syndromes and illustrate the diversity of malignant lymphoproliferative disorders into which agnogenic myeloid metaplasia may evolve in the course of disease. Our experience also demonstrates the ease with which some patients with an ‘end stage’ myeloproliferative disorder may respond to standard chemotherapy designed for the treatment of malignant lymphoma.

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Lymphoblastic leukemic transformation (lymphoblastic crisis) in myelofibrosis and myeloid metaplasia

Cited by 45 publications

References 37 publications

Chronic idiopathic myelofibrosis terminating in extramedullary anaplastic plasmacytoma

Chronic idiopathic myelofibrosis terminating in extramedullary anaplastic plasmacytoma

Acute Lymphoblastic Leukemia in the Course of Polycythemia Vera: A Case Report and Review of Literature

Evolution of Malignant Lymphoma in Agnogenic Myeloid Metaplasia

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