A case report and case review: Chronic myeloid leukemia (CML) blast phase with myelomastocytic differentiation

Jinming Song; Kenian Liu; Javier Pinilla-Ibarz; Hailing Zhang

doi:10.1016/j.lrr.2020.100222

A case report and case review: Chronic myeloid leukemia (CML) blast phase with myelomastocytic differentiation

Leuk Res Rep. 2020 Sep 28:14:100222. doi: 10.1016/j.lrr.2020.100222. eCollection 2020.

Authors

Jinming Song¹, Kenian Liu¹, Javier Pinilla-Ibarz², Hailing Zhang¹

Affiliations

¹ Department of Hematopathology and Lab Medicines, H. Lee Moffitt Cancer Center & Research Institute. 12902 USF Magnolia Drive, Tampa, FL 33612, USA.
² Department of Hematological Malignancies, H. Lee Moffitt Cancer Center & Research Institute. 12902 USF Magnolia Drive, Tampa, FL 33612, USA.

Abstract

We presented a patient with CML who progressed to unclassical blast phase after Tyrosine Kinase Inhibitors (TKIs) therapy. The patient presented with 2 populations of blasts: one with no cytoplasmic granules and was CD117 weak+/tryptase-/CD34- (typical myeloblasts), and another with metochromatic granules in the cytoplasm and was CD117 strong+/tryptase+/CD25+/CD34 subset+ (myelomastocytic blasts). Almost all the cells were positive for BCR/ABL1 fusion and no KT V816F mutation was detected. The patient was misdiagnosed as having blast phase CML with coexisting mast cell leukemia at an outside institute. Three similar cases and previously described myelomastocytic leukemia are reviewed and discussed.

Keywords: Blast phase; Chronic myeloid leukemia; Myelomastocytic Leukemia.

Publication types

Case Reports