病例报告与病例回顾：伴有髓肥大细胞分化的慢性髓性白血病（CML）急变期

A case report and case review: Chronic myeloid leukemia (CML) blast phase with myelomastocytic differentiation.

作者信息

Song Jinming, Liu Kenian, Pinilla-Ibarz Javier, Zhang Hailing

机构信息

Department of Hematopathology and Lab Medicines, H. Lee Moffitt Cancer Center & Research Institute. 12902 USF Magnolia Drive, Tampa, FL 33612, USA.

Department of Hematological Malignancies, H. Lee Moffitt Cancer Center & Research Institute. 12902 USF Magnolia Drive, Tampa, FL 33612, USA.

出版信息

Leuk Res Rep. 2020 Sep 28;14:100222. doi: 10.1016/j.lrr.2020.100222. eCollection 2020.

DOI:10.1016/j.lrr.2020.100222

PMID:33072512

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7549112/

Abstract

We presented a patient with CML who progressed to unclassical blast phase after Tyrosine Kinase Inhibitors (TKIs) therapy. The patient presented with 2 populations of blasts: one with no cytoplasmic granules and was CD117 weak+/tryptase-/CD34- (typical myeloblasts), and another with metochromatic granules in the cytoplasm and was CD117 strong+/tryptase+/CD25+/CD34 subset+ (myelomastocytic blasts). Almost all the cells were positive for BCR/ABL1 fusion and no KT V816F mutation was detected. The patient was misdiagnosed as having blast phase CML with coexisting mast cell leukemia at an outside institute. Three similar cases and previously described myelomastocytic leukemia are reviewed and discussed.

摘要

我们报告了1例慢性髓性白血病（CML）患者，其在接受酪氨酸激酶抑制剂（TKIs）治疗后进展为非典型母细胞期。该患者存在2种母细胞群：一种无细胞质颗粒，CD117弱阳性/类胰蛋白酶阴性/CD34阴性（典型的原始粒细胞），另一种细胞质中有异染性颗粒，CD117强阳性/类胰蛋白酶阳性/CD25阳性/CD34亚群阳性（髓肥大细胞母细胞）。几乎所有细胞BCR/ABL1融合均为阳性，未检测到KT V816F突变。该患者在外部机构被误诊为母细胞期CML合并肥大细胞白血病。对3例类似病例及先前描述的髓肥大细胞白血病进行了回顾和讨论。