Blood Res.  2021 Dec;56(4):345-347. 10.5045/br.2021.2020331.

A case of e1a2 (minor, P190) BCR-ABL1-positive chronic myeloid leukemia in Korea

• Choi YJ
• Heo JY
• Yoo J

• KMID: 2524098
• DOI: http://doi.org/10.5045/br.2021.2020331

Figure

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  Fig. 1 A peripheral blood smear showing leukocytosis with monocytosis (blue arrows), basophilia (red arrow) and left shift (yellow arrow) (white blood cell count 37.59×109/L with 0.19 monocytes and 0.04 basophils, Wright-Giemsa stain, ×400).

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  Fig. 2 Bone marrow biopsy showing hypercellularity (estimated cellularity of 70–90%, Hematoxylin & Eosin stain, ×200).

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  Fig. 3 Dwarf megakaryocytes (yellow arrow) with hypolobated nuclei were seen in the bone marrow (Wright-Giemsa stain, ×400).

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  Fig. 4 Karyotyping results exhibiting 46, XY, t(9;22)(q34;q11.2)[20].

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  Fig. 5 The minor BCR-ABL1 fusion gene was found as a sole rearrangement in the case presented here. Nested reverse transcriptase polymerase chain reaction revealed the minor BCR-ABL1 fusion transcript (P190) with an approximately 320 bp length, indicating it to be the e1a2 type transcript. No amplicons corresponding to the 320 bp position were detected for the major BCR-ABL1 transcripts.

Reference

1. Asinari MB, Zeballos M, Alicia S, Ricchi BN, Basquiera AL. 2015; A case of chronic myeloid leukemia with the m-bcr (p190) molecular rearrangement identified during treatment. Rev Bras Hematol Hemoter. 37:55–7. DOI: 10.1016/j.bjhh.2014.07.024. PMID: 25638769. PMCID: PMC4318852.

2. Yun JW, Yoon J, Kim JW, Kim SH, Jung CW, Kim HJ. 2019; Isolated monocytosis was the flag preceding abnormalities in other parameters of complete blood counts in chronic myeloid leukemia with e1a2 (minor, p190) BCR-ABL1 chimeric transcripts. Precis Future Med. 3:30–5. DOI: 10.23838/pfm.2019.00023.

3. Melo JV. 1996; The diversity of BCR-ABL fusion proteins and their relationship to leukemia phenotype. Blood. 88:2375–84. DOI: 10.1182/blood.V88.7.2375.bloodjournal8872375. PMID: 8839828.

4. Vardiman JW, Melo JV, Baccarani M, Radich JP, Kvasnicka HM. 2017; Chronic myeloid leukaemia, BCR-ABL1-positive. In: Swerdlow SH, Campo E, Harris NL, et al, eds. WHO classification of tumours of haematopoietic and lymphoid tissues. Revised 4th ed. Lyon, France:. IARC Press,. 30–8.

5. Melo JV, Myint H, Galton DA, Goldman JM. 1994; P190BCR-ABL chronic myeloid leukaemia: the missing link with chronic myelomonocytic leukaemia? Leukemia. 8:208–11. PMID: 8289491.

6. Gatti A, Movilia A, Roncoroni L, Citro A, Marinoni S, Brando B. 2018; Chronic myeloid leukemia with P190 BCR-ABL translocation and persistent moderate monocytosis: a case report. J Hematol. 7:120–3. DOI: 10.14740/jh421w. PMID: 32300425. PMCID: PMC7155835.

7. Gong Z, Medeiros LJ, Cortes JE, et al. 2017; Clinical and prognostic significance of e1a2 BCR-ABL1 transcript subtype in chronic myeloid leukemia. Blood Cancer J. 7:e583. DOI: 10.1038/bcj.2017.62. PMID: 28708130. PMCID: PMC5549254.