Ann Lab Med.  2017 Mar;37(2):166-168. 10.3343/alm.2017.37.2.166.

A Case of Therapy-Related Acute Leukemia With Mixed Phenotype With BCR-ABL1 After Treatment of Diffuse Large B-Cell Lymphoma

• Yang D
• Cho SR
• Jung S
• Lee W
• Hwang HY
• Lee HS
• Kim YS
• Choi JR
• Kim MH

• KMID: 2373637
• DOI: http://doi.org/10.3343/alm.2017.37.2.166

Abstract

No abstract available.

MeSH Terms

Aged
Antineoplastic Combined Chemotherapy Protocols/adverse effects
Bone Marrow Cells/cytology/pathology
Female
Flow Cytometry
Fusion Proteins, bcr-abl/*genetics
Granulocyte Colony-Stimulating Factor/therapeutic use
Humans
Immunophenotyping
Leukemia/*diagnosis/etiology
Lymphoma, Large B-Cell, Diffuse/*drug therapy
Phenotype
Rituximab/administration & dosage
Fusion Proteins, bcr-abl
Granulocyte Colony-Stimulating Factor
Rituximab

Figure

• 

  Fig. 1 Bone marrow aspirate smear showing leukemic blasts. (A) Increased blasts with medium cell size, oval to round shape, vesicular nuclei, fine chromatin patterns, and basophilic cytoplasm (×1,000, Wright-Giemsa stain), (B) More than 3% of blasts were positive for myeloperoxidase (×1,000, myeloperoxidase stain).

• 

  Fig. 2 Flow cytometry analysis of the bone marrow cells (Cytomics FC500 flow cytometer, Beckman Coulter, Fullerton, CA, USA). By CD45/SS linear gating, a relatively homogenous population of blasts consist 38.46% of all bone marrow cells. These cells were positive for both T-lymphoid (cytoplasmic CD3, CD5, and CD7) and myeloid differentiation (cytoplasmic MPO, CD13, and CD33) markers.Abbreviations: FITC, fluorescein isothiocyanate; MPO, myeloperoxidase.

Reference

1. Leone G, Fianchi L, Voso MT. Therapy-related myeloid neoplasms. Curr Opin Oncol. 2011; 23:672–680. PMID: 21918440.

2. Cho JH, Hur M, Moon HW, Yun YM, Ko YS, Kim WS, et al. Therapy-related acute leukemia with mixed phenotype and t(9;22)(q32;q11.2): a case report and review of the literature. Hum Pathol. 2012; 43:605–609. PMID: 22036054.

3. Roberts E 3rd, Oncale M, Safah H, Schmieg J. Therapy-related T/Myeloid mixed phenotype acute leukemia in a patient treated with chemotherapy for cutaneous diffuse large B cell lymphoma. J La State Med Soc. 2016; 168:16–20. PMID: 26986862.

4. Vardiman JW, Thiele J, Arber DA, Brunning RD, Borowitz MJ, Porwit A, et al. The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes. Blood. 2009; 114:937–951. PMID: 19357394.

5. Bene MC, Castoldi G, Knapp W, Ludwig WD, Matutes E, Orfao A, et al. Proposals for the immunological classification of acute leukemias. European Group for the Immunological Characterization of Leukemias (EGIL). Leukemia. 1995; 9:1783–1786. PMID: 7564526.

6. Cho YU, Chi HS, Park CJ, Jang S, Seo EJ. Rapid detection of prognostically significant fusion transcripts in acute leukemia using simplified multiplex reverse transcription polymerase chain reaction. J Korean Med Sci. 2012; 27:1155–1161. PMID: 23091311.

7. Matutes E, Pickl WF, Van’t Veer M, Morilla R, Swansbury J, Strobl H, et al. Mixed-phenotype acute leukemia: clinical and laboratory features and outcome in 100 patients defined according to the WHO 2008 classification. Blood. 2011; 117:3163–3171. PMID: 21228332.

8. Carbonell F, Swansbury J, Min T, Matutes E, Farahat N, Buccheri V, et al. Cytogenetic findings in acute biphenotypic leukaemia. Leukemia. 1996; 10:1283–1287. PMID: 8709632.

9. Demiriz IŞ, Tekgünduz E, Bozdağ SC, Altuntaş F. Chronic myeloid leukemia as a secondary malignancy following treatment of diffuse large B-cell lymphoma. Turk J Haematol. 2014; 31:92–84. PMID: 24764737.

10. Inukai T, Sugita K, Mitsui K, Iijima K, Goi K, Tezuka T, et al. Participation of granulocyte colony-stimulating factor in the growth regulation of leukemia cells from Philadelphia chromosome-positive acute leukemia and blast crisis of chronic myeloid leukemia. Leukemia. 2000; 14:1386–1395. PMID: 10942233.