Shivarov V, Stoimenov A, Galabova I, Balatzenko G, Guenova M. Very early onset of an acute myeloid leukemia in an adult patient with B-cell lymphoblastic leukemia.
Int J Lab Hematol 2009;
31:106-13. [PMID:
19143872 DOI:
10.1111/j.1751-553x.2007.00968.x]
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Abstract
We report on a case of a 30-year-old male with acute B-lymphoblastic leukemia (B-ALL) with immunophenotype CD19(+), CD22(+), CD20(+), CD10(+), with aberrant expression of CD13 and CD117, and IgH gene rearrangements. Three months after treatment with GMALL-2003 and Ida/FLAG protocols bone marrow showed predominance of blasts with myeloid morphology and phenotype MPO(+), CD13(+), CD33(+), CD64(+), CD15(+), CD56(+), EVI-1 gene overexpression and lack of IgH rearrangements. The case is the first report of a very early emergence of myeloid leukemia during the induction treatment for B-ALL in an adult patient. Different pathogenetic mechanisms are discussed - clonal evolution or selection, lineage switch or development of a de novo or therapy-induced leukemia.
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