Zaher Chakhachiro 1 , C Cameron Yin 1 , Lynne V Abruzzo 1 , Tariq N Aladily 1 , Lynn L Barron 1 , Haley E Banks 1 , Deborah A Thomas 1 , Michael Keating 1 , L Jeffrey Medeiros 1 , Yang O Huh 2 Show Affiliations »
Abstract
OBJECTIVES: B-lymphoblastic leukemia (B-LBL) arising in patients with chronic lymphocytic leukemia (CLL) is exceedingly rare and poorly characterized. METHODS: We describe four patients with CLL and concurrent or subsequent B-LBL diagnosed by morphologic, immunophenotypic, cytogenetic, and molecular analysis and reviewed the literature. RESULTS: In three patients, B-LBL followed CLL by 5 to 15 years, and in one patient, B-LBL was diagnosed simultaneously with CLL. In all cases, the CLL had a typical immunophenotype, and the B-LBL blasts showed an immature B-cell immunophenotype with expression of CD10, CD19, and TdT and absence of surface immunoglobulin. In two patients, B-LBL blasts harbored t(9;22)(q34;q11.2)/BCR-ABL1. We sequenced the IGHV genes in both CLL and B-LBL in two patients and showed that IGHV usage differed. CONCLUSIONS: Our data suggest that at least some cases of B-LBL arising in patients with CLL are independent, secondary neoplasms rather than a manifestation of histologic transformation. Copyright© by the American Society for Clinical Pathology.
OBJECTIVES: B-lymphoblastic leukemia (B-LBL) arising in patients with chronic lymphocytic leukemia (CLL) is exceedingly rare and poorly characterized. METHODS: We describe four patients with CLL and concurrent or subsequent B-LBL diagnosed by morphologic, immunophenotypic, cytogenetic, and molecular analysis and reviewed the literature. RESULTS: In three patients , B-LBL followed CLL by 5 to 15 years, and in one patient , B-LBL was diagnosed simultaneously with CLL. In all cases, the CLL had a typical immunophenotype, and the B-LBL blasts showed an immature B-cell immunophenotype with expression of CD10 , CD19 , and TdT and absence of surface immunoglobulin. In two patients , B-LBL blasts harbored t(9;22)(q34;q11.2)/BCR-ABL1 . We sequenced the IGHV genes in both CLL and B-LBL in two patients and showed that IGHV usage differed. CONCLUSIONS: Our data suggest that at least some cases of B-LBL arising in patients with CLL are independent, secondary neoplasms rather than a manifestation of histologic transformation. Copyright© by the American Society for Clinical Pathology.
Entities: Disease
Gene
Species
Keywords:
B-lymphoblastic leukemia; BCR-ABL1; Chronic lymphocytic leukemia; Philadelphia chromosome; t(9;22); transformation
Mesh： See more »
Year: 2015
PMID： 26185320 DOI： 10.1309/AJCPXE5VMONMVLZ0
Source DB: PubMed Journal: Am J Clin Pathol ISSN： 0002-9173 Impact factor: 2.493