慢性髓性白血病的 T 细胞母细胞危象表现为同时存在 p210 和 p190 BCR-ABL 转录本和 t(10;11)(q11;p15)。
T-cell blast crisis of chronic myelogenous leukemia presented with coexisting p210 and p190 BCR-ABL transcripts and t(10;11)(q11;p15).
机构信息
The Haematology Department, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
出版信息
J Clin Lab Anal. 2020 Jun;34(6):e23241. doi: 10.1002/jcla.23241. Epub 2020 Feb 13.
BACKGROUND
Blast transformation of chronic myelogenous leukemia (CML) to T lymphoblastic lymphoma/acute lymphoblastic leukemia (T-LBL/ALL) is rare, and the molecular mechanism is still unclear.
CASE REPORT
A 28-year-old woman who developed T-ALL with coexpressing both p210 and p190 BCR-ABL transcripts five years after the initial diagnosis of CML in chronic phase. The proliferation of bone marrow was extremely active with blast cells over 20%. Chromosome analysis revealed t(9;22)(q34;q11) and t(10;11)(q25;p15). Flow immunophenotyping showed that blasts expressed CD4, CD7, CD11b, CD38, CD34, CD33, and cCD3.
CONCLUSION
It is the first T-cell blast of CML case with coexisting p210 and p190 as well as additional chromosome translocations. Through review this case and previous reports, we will reveal that CML patients with T-lymphocyte transformation depend on potential molecular and pathological mechanism.
背景
慢性髓细胞白血病（CML）向 T 淋巴母细胞淋巴瘤/急性淋巴细胞白血病（T-LBL/ALL）的急变较为罕见，其分子机制尚不清楚。
病例报告
一名 28 岁女性，在 CML 慢性期初诊五年后出现 T-ALL，同时表达 p210 和 p190 BCR-ABL 转录本。骨髓增生极度活跃，原始细胞超过 20%。染色体分析显示 t(9;22)(q34;q11) 和 t(10;11)(q25;p15)。流式免疫表型显示原始细胞表达 CD4、CD7、CD11b、CD38、CD34、CD33 和 cCD3。
结论
这是首例共存 p210 和 p190 以及额外染色体易位的 CML 伴 T 细胞急变病例。通过回顾本病例和以往报告，我们将揭示 CML 患者的 T 淋巴细胞转化依赖于潜在的分子和病理机制。
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