Blood Res.  2021 Dec;56(4):339-342. 10.5045/br.2021.2021093.

Therapy-related acute myeloid leukemia in a patient with B-cell acute lymphoblastic leukemia

• Gajendra S
• Gore AR
• Jha B
• Sood N
• Bhargava M

• KMID: 2524096
• DOI: http://doi.org/10.5045/br.2021.2021093

Figure

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  Fig. 1 Bone marrow aspirate showed lymphoblasts with scanty agranular cytoplasm (A). Bone marrow biopsy (Haematoxylin and Eosin stain, ×400) with IHC showed positivity for CD10 and PAX5 and negativity for CD33 (B).

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  Fig. 2 Bone marrow aspirate showed myeloblasts that were larger in size and had moderate granular cytoplasm (A). Bone marrow biopsy (Haematoxylin and Eosin stain, ×400) with IHC showed positivity for CD33 and negativity for CD10 and PAX5 (B).

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  Fig. 3 Karyogram showed 46,XX, -4, +8, der(17) t(15;17)(q24;q23), del(17)(p13), der(20) t(10;20) (q11.2; q13.3), +der(11)t(5;11)(q31;q13), using GTG staining and banding method, ×100 oil immersion, and Carl Zeiss Axioscope Z2, and was processed using IKAROS software (A). Interphase nuclei and metaphase showed monoallelic deletion of TP53 gene localized on 17p13.1 by FISH using LSI 17p13.1(TP53/CEN17) deletion probe [TP53-red, CEN17-green], Zytovysion, Germany (B).

Reference

1. Verma D, O'Brien S, Thomas D, et al. 2009; Therapy-related acute myelogenous leukemia and myelodysplastic syndrome in patients with acute lymphoblastic leukemia treated with the hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone regimens. Cancer. 115:101–6. DOI: 10.1002/cncr.24005. PMID: 19090005. PMCID: PMC4180242.

2. Morton LM, Dores GM, Tucker MA, et al. 2013; Evolving risk of therapy-related acute myeloid leukemia following cancer chemotherapy among adults in the United States, 1975-2008. Blood. 121:2996–3004. DOI: 10.1182/blood-2012-08-448068. PMID: 23412096. PMCID: PMC3624944.

3. Kayser S, Döhner K, Krauter J, et al. 2011; The impact of therapy-related acute myeloid leukemia (AML) on outcome in 2853 adult patients with newly diagnosed AML. Blood. 117:2137–45. DOI: 10.1182/blood-2010-08-301713. PMID: 21127174.

4. Wu B, Jug R, Luedke C, et al. 2017; Lineage switch between B-lymphoblastic leukemia and acute myeloid leukemia intermediated by "Occult" myelodysplastic neoplasm: two cases of adult patients with evidence of genomic instability and clonal selection by chemotherapy. Am J Clin Pathol. 148:136–47. DOI: 10.1093/ajcp/aqx055. PMID: 28898985.

5. Pagano L, Annino L, Ferrari A, et al. 1998; Secondary haematological neoplasm after treatment of adult acute lymphoblastic leukemia: analysis of 1170 adult ALL patients enrolled in the GIMEMA trials. Gruppo Italiano Malattie Ematologiche Maligne dell'Adulto. Br J Haematol. 100:669–76. DOI: 10.1046/j.1365-2141.1998.00616.x. PMID: 9531332.

6. Tavernier E, Le QH, de Botton S, et al. 2007; Secondary or concomitant neoplasms among adults diagnosed with acute lymphoblastic leukemia and treated according to the LALA-87 and LALA-94 trials. Cancer. 110:2747–55. DOI: 10.1002/cncr.23097. PMID: 17963265.

7. Grosicki S, Barchnicka A, Bodzenta E, Haus O, Jaśkowiec A. 2013; Secondary acute myeloid leukemia (sAML) immediately after intensive chemotherapy of acute lymphoblastic leukemia (ALL). J Leuk. 1:1000102. DOI: 10.4172/2329-6917.1000102.