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

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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Main Authors: Parikshit Padhi, Margarita Topalovski, Radwa El Behery, Eduardo S. Cantu, Ramadevi Medavarapu
Format: Article
Language:English
Published: Hindawi Limited 2018-01-01
Series:Case Reports in Oncological Medicine
Online Access:http://dx.doi.org/10.1155/2018/7276128
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spelling doaj-50161695414b4c1eabf69f8a85ca99a32020-11-24T21:16:58ZengHindawi LimitedCase Reports in Oncological Medicine2090-67062090-67142018-01-01201810.1155/2018/72761287276128A Rare Case of Chronic Myelogenous Leukemia Presenting as T-Cell Lymphoblastic CrisisParikshit Padhi0Margarita Topalovski1Radwa El Behery2Eduardo S. Cantu3Ramadevi Medavarapu4Department of Hematology and Medical Oncology, Memorial Medical Center, Las Cruces, NM, USADepartment of Pathology, Memorial Medical Center, Las Cruces, NM, USAHematopathologist, Integrated Oncology, Phoenix, AZ, USASenior Clinical Laboratory Directory, Cytogenetics, Integrated Oncology, Phoenix, AZ, USAAssistant Professor, Hematology and Oncology, University of New Mexico, Memorial Cancer Center, Las Cruces, NM, USAChronic 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.http://dx.doi.org/10.1155/2018/7276128
collection DOAJ
language English
format Article
sources DOAJ
author Parikshit Padhi
Margarita Topalovski
Radwa El Behery
Eduardo S. Cantu
Ramadevi Medavarapu
spellingShingle Parikshit Padhi
Margarita Topalovski
Radwa El Behery
Eduardo S. Cantu
Ramadevi Medavarapu
A Rare Case of Chronic Myelogenous Leukemia Presenting as T-Cell Lymphoblastic Crisis
Case Reports in Oncological Medicine
author_facet Parikshit Padhi
Margarita Topalovski
Radwa El Behery
Eduardo S. Cantu
Ramadevi Medavarapu
author_sort Parikshit Padhi
title 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_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_sort rare case of chronic myelogenous leukemia presenting as t-cell lymphoblastic crisis
publisher Hindawi Limited
series Case Reports in Oncological Medicine
issn 2090-6706
2090-6714
publishDate 2018-01-01
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.
url http://dx.doi.org/10.1155/2018/7276128
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