Extramedullary T-lymphoblastic blast crisis in chronic myelogenous leukemia: A case report of successful diagnosis and treatment

Zeng,Dong-Feng; Chang,Cheng; Li,Jie-Ping; Kong,Pei-Yan; Zhang,Xi; Gao,Lei

doi:10.3892/etm.2015.2173

Extramedullary T-lymphoblastic blast crisis in chronic myelogenous leukemia: A case report of successful diagnosis and treatment

Authors:
- Dong-Feng Zeng
- Cheng Chang
- Jie-Ping Li
- Pei-Yan Kong
- Xi Zhang
- Lei Gao
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Affiliations: Department of Hematology, Xinqiao Hospital, The Third Military Medical University, Chongqing 400037, P.R. China
Published online on: January 9, 2015 https://doi.org/10.3892/etm.2015.2173
Pages: 850-852

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Abstract

Extramedullary T-lymphoblastic blast crisis of chronic myelogenous leukemia (CML) is uncommon and the prognosis is poor. It was usually misdiagnosed as the co-existence of T-lymphoblastic lymphoma (T-LBL) and CML. In the present study, we report a patient with CML, who developed extramedullary T-lymphoblastic blast crisis and was successfully treated with human leukocyte antigen (HLA)-mismatched stem cell transplantation. The patient was a 44-year-old man who presented with lymphadenectasis and leucocytosis prior to diagnosis. The bone marrow smear, biopsy and fluorescence in situ hybridization (FISH) of Breakpoint Cluster Region/ Abelson murine leukaemia (BCR/ABL) supported the diagnosis of CML in the chronic phase, while the immunohistochemistry of lymph nodes supported the diagnosis of T-LBL. The FISH test for BCR/ABL in lymph node blast cells was performed and the result was positive; therefore, the patient was diagnosed with extramedullary T-lymphoblastic blast crisis of CML. After several courses of combined chemotherapy, the patient was treated with HLA-mismatched stem cell transplantation and obtained continuous remission for 51 months until the present (September 2013).

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