Precursor B cell lymphoid blast crisis of chronic myeloid leukemia with novel chromosomal abnormalities: A case report

Al‑Khallaf,Hamoud; Alali,Hani; Alkhatti,Adil

doi:10.3892/ol.2018.9497

Precursor B cell lymphoid blast crisis of chronic myeloid leukemia with novel chromosomal abnormalities: A case report

Authors:
- Hamoud Al‑Khallaf
- Hani Alali
- Adil Alkhatti
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Affiliations: Department of Pathology and Laboratory Medicine, King Fahad Specialist Hospital, Dammam 32253, Saudi Arabia, Cancer Institute, Johns Hopkins Aramco Healthcare, Dhahran 34465, Saudi Arabia
Published online on: September 25, 2018 https://doi.org/10.3892/ol.2018.9497
Pages: 6691-6696

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Abstract

Chronic myeloid leukemia (CML) is a clonal hematopoietic stem cell disorder. It is characterized by the presence of the Philadelphia (Ph) chromosome, t(9;22)(q34.1;q11.2), which carries the BCR‑ABL1 fusion gene. Tyrosine kinase inhibitors (TKIs) have markedly changed the treatment approach of CML and have become the first‑line agents for almost all CML patients. However, certain patients experience resistance to these medications, which occurs through several mechanisms, including the accumulation of TKI‑resistant chromosomal abnormalities. The present study reports a case of a 27‑year‑old Saudi male with CML receiving TKI treatment, who presented with precursor B‑cell lymphoblastic crisis demonstrating the presence of the novel combined chromosomal abnormalities; non‑Ph der(22), i(9) and der(20), carrying the BCR‑ABL1 fusion gene. This case report adds to the literature on novel TKI‑resistance‑conferring chromosomal abnormalities and links them to precursor B‑cell lymphoblastic crisis.

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