Xu, K;
Nacheva, E;
(2023)
Chronic myeloid leukaemia (CML) presenting in B-lymphoblastic crisis: a diagnostic challenge.
Journal of Hematopathology
, 16
(4)
pp. 243-245.
10.1007/s12308-023-00560-9.
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Abstract
We report the case of a 75-year-old female presented with lethargy, Hb 93 g/L, WBC 64 x 109/L, platelet 110 x 109/L. Blood film showed blasts, myelocytes, metamyelocytes, neutrophils. Quantitative PCR detected p210 BCR::ABL1 transcript in sorted CD19+ cells, and sorted CD19- cells. Bone marrow smear was packed with blasts. Flow cytometry and bone marrow histology revealed B-lymphoblasts. The patient was diagnosed with CML Blymphoblastic crisis. CML presenting in B-lymphoblastic crisis could resemble features of de novo Ph+ B-ALL, which makes the diagnosis challenging. These patients have inferior outcomes; therefore, it is important to distinguishing CML B -lymphoblastic crisis from de novo Ph+ B-ALL. Positive BCR::ABL1 in both CD19+ and CD19- sorted cell populations support the diagnosis of CML B-lymphoblastic crisis in this case.
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