T‐lymphoid or T/myeloid blast phase of chronic myeloid leukemia in the era of tyrosine kinase inhibitor therapy: a report of 14 cases

Gong, Zimu; Xie, Wei; Wang, W.; Chen, Z.; Xu, Jie; Yuan, Ji; Zhou, Yi; Wang, D.; Medeiros, L. Jeffrey; Hu, Shimin

doi:10.1111/ijlh.12605

Cited by 3 publications

(4 citation statements)

References 15 publications

(15 reference statements)

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“…13 The incidence of each is rare, with T lymphoblastic crisis occurring in roughly 1.3% of blast crisis CML cases, and less than 5% of BCR-ABL1þ ALL are of T lineage. 4,14 The p210 form of the BCR-ABL1 translocation in this case does raise the possibility of T-cell lymphoblastic crisis of CML. However, the patient had no prior history of CML and no BCR-ABL1 transcript was detected in the repeated bone marrow cells post-chemotherapy and before haploidentical stem cell transplantation.…”

Section: Discussionmentioning

confidence: 81%

Philadelphia chromosome-positive T-cell acute lymphoblastic leukemia: a case report

Dong,

Darwish,

Howard

et al. 2024

J Int Med Res

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Philadelphia chromosome-positive (Ph+) T-cell acute lymphoblastic leukemia (T-ALL) is a rare and aggressive type of acute leukemia. The Philadelphia chromosome is the hallmark of chronic myeloid leukemia (CML). The differentiation between Ph+ T-ALL and T-cell lymphoblastic crisis of CML may be problematic in some cases. Here, we report a rare case of de novo Ph+ T-ALL that presented a diagnostic challenge. The overall clinical, immunophenotypic, cytogenetic, and xenotransplantation results suggest a diagnosis of Ph+ T-ALL. The patient was treated with induction chemotherapy including imatinib followed by haploidentical stem cell transplantation and achieved complete remission.

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Section: Discussionmentioning

confidence: 81%

Philadelphia chromosome-positive T-cell acute lymphoblastic leukemia: a case report

Dong,

Darwish,

Howard

et al. 2024

J Int Med Res

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“…The incidence of each is rare. Only 1.3% of CML‐BP have a T‐lymphoid BP and less than 5% of BCR‐ABL1 fusion‐positive ALL are T‐cell ALL . Distinguishing CML‐BP from de novo ALL can be very challenging, especially if there is no prior history of CML, although the lack of TCR beta and gamma rearrangement would favor leukemia arising in an early progenitor cell .…”

Section: Discussionmentioning

confidence: 99%

“…However, in about 20% of the cases, the MRD was discordant and the fusion gene was present not only in the malignant blasts but also in nonmalignant cells, suggesting that the fusion might have occurred in a multipotent progenitor cell. The BCR‐ABL1 fusion gene is almost always found in malignant B cells and has been reported only rarely in malignant T cells . We describe a patient with BCR‐ABL1 transcripts in the malignant T cells and in a subpopulation of nonmalignant B cells.…”

Section: Introductionmentioning

confidence: 94%

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Evidence for BCR/ABL1‐positive T‐cell acute lymphoblastic leukemia arising in an early lymphoid progenitor cell

Ragg

Zehentner²,

Loken³

et al. 2019

Pediatric Blood & Cancer

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BCR‐ABL1‐positive leukemias have historically been classified as either chronic myelogenous leukemia or Ph+ acute lymphoblastic leukemia. Recent analyses suggest there may be a wider range of subtypes. We report a patient with BCR‐ABL1 fusion positive T‐cell ALL with a previously undescribed cell distribution of the fusion gene. The examination of sorted cells by fluorescence in situ hybridization showed the BCR‐ABL1 fusion in the malignant T cells and a subpopulation of the nonmalignant B cells, but not nonmalignant T cells or myeloid or CD34+ progenitor cells providing evidence that the fusion may have occurred in an early lymphoid progenitor.

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Low‐Level BCR::ABL1 Transcript at Diagnosis in Childhood Leukemia: A 10‐Year Single Institution Study

Cain,

Mirochnik,

Stevens

et al. 2024

Genes Chromosomes & Cancer

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IntroductionPhiladelphia chromosome‐positive (Ph+) acute lymphoblastic leukemia (ALL) is a high risk form of ALL associated with dismal outcomes in the pre‐tyrosine kinase inhibitor (TKI) era. Addition of a TKI to chemotherapy improves outcomes. Therefore, testing for the presence of the Philadelphia chromosome by at least two methods at the time of diagnosis is critical. Diagnostic testing may include karyotype, fluorescent in situ hybridisation (FISH), and RT‐PCR for the BCR::ABL1 transcript. The significance of low‐level BCR::ABL1 transcript by RT‐PCR in the absence of the Philadelphia chromosome on karyotype or by FISH is unknown.MethodsThis is a retrospective review of children diagnosed with acute leukemia at our institution from 2010 to 2020. Those positive for the BCR::ABL1 transcript by qualitative RT‐PCR, and negative for t(9;22) by karyotype or FISH were analyzed for demographics, cytogenetic and molecular features at diagnosis and relapse, treatment and outcomes. The Kaplan–Meier method was used to estimate event‐free and overall survival.ResultsForty‐seven of 306 (15%) patients with Ph‐ ALL had low‐level BCR::ABL1 detected by RT‐PCR. Most (77%) had B‐cell ALL. The e1a2 transcript was detected most frequently, in 43 (91%) patients. BCR::ABL1 was quantifiable in 12/43 (28%) patients, with a median of 0.0008% (range 0.0003–0.095%). Seven patients (15%) relapsed. No patient with low‐level BCR::ABL1 at diagnosis developed Ph + ALL at relapse. There was no difference in 5‐year event‐free (77% versus 81%, p = 0.407) or overall survival (86% versus 91%, p = 0.3) between children with low‐level BCR::ABL1 (n = 47) and those without (n = 259).ConclusionBCR::ABL1 low‐level positivity in children with newly diagnosed Ph‐ ALL is a relatively common finding and did not adversely affect outcome for patients treated using a contemporary risk‐adapted approach.

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T‐lymphoid or T/myeloid blast phase of chronic myeloid leukemia in the era of tyrosine kinase inhibitor therapy: a report of 14 cases

Cited by 3 publications

References 15 publications

Philadelphia chromosome-positive T-cell acute lymphoblastic leukemia: a case report

Philadelphia chromosome-positive T-cell acute lymphoblastic leukemia: a case report

Evidence for BCR/ABL1‐positive T‐cell acute lymphoblastic leukemia arising in an early lymphoid progenitor cell

Low‐Level BCR::ABL1 Transcript at Diagnosis in Childhood Leukemia: A 10‐Year Single Institution Study

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