Autopsy and Case Reports
https://www.autopsyandcasereports.org/article/doi/10.4322/acr.2023.426
Autopsy and Case Reports
Clinical Case Report

Pediatric chronic myeloid leukemia in myeloid blast crisis

Biswajit Dey; Anirban Dutta

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Abstract

Chronic myeloid leukemia (CML) accounts for 2-3% of childhood leukemias. About 5% of cases present in a blastic phase of CML which clinically and morphologically mimics more common acute leukemias of childhood. We report a case of a 3-year-old male who presented with gradual onset swelling of the abdomen and extremities along with generalized weakness. Examination revealed massive splenomegaly, pallor, and pedal edema. Initial workup showed anemia, thrombocytopenia, and leukocytosis (120,000/uL) with a blast percentage of 35%. Blasts were positive for CD13, CD33, CD117, CD34 and HLA-DR, and stained negative for Myeloperoxidase and Periodic Acid Schiff. Fluorescence in situ hybridization was positive for b3a2/e14a2 junction BCR-ABL1 transcript and negative for RUNX1-RUNX1T1/t(8;21), clinching the diagnosis of CML in myeloid blast crisis. The patient expired within 17 days of diagnosis and initiation of therapy.

Keywords

Blast Crisis, Leukemia, Myelogenous, Chronic, BCR-ABL Positive, Leukemia, Myeloid, Leukemia, Myeloid, Acute, Pediatrics

References

1 Bhattacharya J, Gupta R. Pediatric chronic myeloid leukemia presenting in a mixed phenotypic blast crisis: a rare occurrence. Turk J Haematol. 2019;36(3):206-8. PMid:30905138.

2 Fuente J, Baruchel A, Biondi A, et al. Managing children with chronic myeloid leukemia (CML): recommendations for the management of CML in children and young people up to the age of 18 years. Br J Haematol. 2014;167(1):33-47. http://dx.doi.org/10.1111/bjh.12977. PMid:24976289.

3 Millot F, Traore P, Guilhot J, et al. Clinical and biological features at diagnosis in 40 children with chronic myeloid leukemia. Pediatrics. 2005;116(1):140-3. http://dx.doi.org/10.1542/peds.2004-2473. PMid:15995044.

4 Sazawal S, Singh K, Chhikara S, et al. Pediatric chronic myeloid leukemia with myeloid blast crisis and complex karyotype at presentation. Indian J Cancer. 2020;57(3):343-5. PMid:32769290.

5 Jin M, Xuan C, Gao J, et al. Chronic myeloid leukemia extramedullary blast crisis presenting as central nervous system leukemia: a case report. Medicine. 2018;97(45):e13131. http://dx.doi.org/10.1097/MD.0000000000013131. PMid:30407337.

6 Belgaumi AF, Al-Shehri A, Ayas M, et al. Clinical characteristics and treatment outcome of pediatric patients with chronic myeloid leukemia. Haematologica. 2010;95(7):1211-5. http://dx.doi.org/10.3324/haematol.2009.015180. PMid:20410182.

7 Pakakasama S, Kajanachumpol S, Kanjanapongkul S, et al. Simple multiplex RT-PCR for identifying common fusion transcripts in childhood acute leukemia. Int J Lab Hematol. 2008;30(4):286-91. http://dx.doi.org/10.1111/j.1751-553X.2007.00954.x. PMid:18665825.

8 Bao F, Munker R, Lowery C, et al. Comparison of FISH and quantitative RT-PCR for the diagnosis and follow-up of BCR-ABL-positive leukemias. Mol Diagn Ther. 2007;11(4):239-45. http://dx.doi.org/10.1007/BF03256245. PMid:17705578.

9 Neuendorff NR, Burmeister T, Dörken B, Westermann J. BCR-ABL-positive acute myeloid leukemia: a new entity? Analysis of clinical and molecular features. Ann Hematol. 2016;95(8):1211-21. http://dx.doi.org/10.1007/s00277-016-2721-z. PMid:27297971.

10 Swerdlow SH, Campo E, Harris NL, et al. Acute myeloid leukemia and related precursor neoplasms. In: Swerdlow SH, Campo E, Harris NL, et al., editors. WHO classification of tumours of haematopoietic and lymphoid tissues. 4th ed. Lyon: IACR; 2017. Volume 2; p. 140-1.
 


Submitted date:
02/15/2022

Accepted date:
03/13/2023

Publication date:
04/13/2023

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