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A Rare Case of Chronic Myelogenous Leukemia Presenting as T-Cell Lymphoblastic Crisis

Chronic Myelogenous Leukemia in blast crisis can manifest as either myeloid (more common) or lymphoid blast crisis. Most lymphoblastic crises are of B-cell lineage. T-cell blast crisis is extremely rare, with only a few reported cases. We present a case of a middle-aged man who was diagnosed with CM...

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Autores principales: Padhi, Parikshit, Topalovski, Margarita, El Behery, Radwa, Cantu, Eduardo S., Medavarapu, Ramadevi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6276408/
https://www.ncbi.nlm.nih.gov/pubmed/30581639
http://dx.doi.org/10.1155/2018/7276128
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author Padhi, Parikshit
Topalovski, Margarita
El Behery, Radwa
Cantu, Eduardo S.
Medavarapu, Ramadevi
author_facet Padhi, Parikshit
Topalovski, Margarita
El Behery, Radwa
Cantu, Eduardo S.
Medavarapu, Ramadevi
author_sort Padhi, Parikshit
collection PubMed
description Chronic Myelogenous Leukemia in blast crisis can manifest as either myeloid (more common) or lymphoid blast crisis. Most lymphoblastic crises are of B-cell lineage. T-cell blast crisis is extremely rare, with only a few reported cases. We present a case of a middle-aged man who was diagnosed with CML on peripheral blood and bone marrow biopsy. Because of a generalized lymphadenopathy noted at the time of diagnosis, a lymph node biopsy was also performed, which revealed a T-cell lymphoblastic leukemia/lymphoma, BCR/ABL1 positive, with clonal evolution. This is a very rare manifestation of CML in blast crisis with no standard treatment and with poor outcomes despite chemotherapy or allogeneic stem cell transplant. Given its rarity, it would be difficult to develop standard chemotherapy protocols. We believe the treatment for this condition should be similar to any lymphoid blast crisis. The patient was treated with induction chemotherapy (hyper-CVAD regimen) plus dasatinib for 3 cycles followed by sibling-donor allogeneic stem cell transplant and is currently on maintenance dasatinib and has minimal residual disease at this time.
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spelling pubmed-62764082018-12-23 A Rare Case of Chronic Myelogenous Leukemia Presenting as T-Cell Lymphoblastic Crisis Padhi, Parikshit Topalovski, Margarita El Behery, Radwa Cantu, Eduardo S. Medavarapu, Ramadevi Case Rep Oncol Med Case Report Chronic Myelogenous Leukemia in blast crisis can manifest as either myeloid (more common) or lymphoid blast crisis. Most lymphoblastic crises are of B-cell lineage. T-cell blast crisis is extremely rare, with only a few reported cases. We present a case of a middle-aged man who was diagnosed with CML on peripheral blood and bone marrow biopsy. Because of a generalized lymphadenopathy noted at the time of diagnosis, a lymph node biopsy was also performed, which revealed a T-cell lymphoblastic leukemia/lymphoma, BCR/ABL1 positive, with clonal evolution. This is a very rare manifestation of CML in blast crisis with no standard treatment and with poor outcomes despite chemotherapy or allogeneic stem cell transplant. Given its rarity, it would be difficult to develop standard chemotherapy protocols. We believe the treatment for this condition should be similar to any lymphoid blast crisis. The patient was treated with induction chemotherapy (hyper-CVAD regimen) plus dasatinib for 3 cycles followed by sibling-donor allogeneic stem cell transplant and is currently on maintenance dasatinib and has minimal residual disease at this time. Hindawi 2018-11-18 /pmc/articles/PMC6276408/ /pubmed/30581639 http://dx.doi.org/10.1155/2018/7276128 Text en Copyright © 2018 Parikshit Padhi et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Padhi, Parikshit
Topalovski, Margarita
El Behery, Radwa
Cantu, Eduardo S.
Medavarapu, Ramadevi
A Rare Case of Chronic Myelogenous Leukemia Presenting as T-Cell Lymphoblastic Crisis
title A Rare Case of Chronic Myelogenous Leukemia Presenting as T-Cell Lymphoblastic Crisis
title_full A Rare Case of Chronic Myelogenous Leukemia Presenting as T-Cell Lymphoblastic Crisis
title_fullStr A Rare Case of Chronic Myelogenous Leukemia Presenting as T-Cell Lymphoblastic Crisis
title_full_unstemmed A Rare Case of Chronic Myelogenous Leukemia Presenting as T-Cell Lymphoblastic Crisis
title_short A Rare Case of Chronic Myelogenous Leukemia Presenting as T-Cell Lymphoblastic Crisis
title_sort rare case of chronic myelogenous leukemia presenting as t-cell lymphoblastic crisis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6276408/
https://www.ncbi.nlm.nih.gov/pubmed/30581639
http://dx.doi.org/10.1155/2018/7276128
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