Chronic myelogenous leukemia. Development of blast crisis with both lymphoid and myeloid features.
A 50-year-old man had chronic myelogenous leukemia and entered a blast crisis that was both morphologically and histochemically lymphoid. The blasts contained terminal deoxyribonucleotidyl transferase and expressed lymphoblastic leukemia-associated antigen. He rapidly entered remission with vincristine sulfate and prednisone therapy. Nevertheless, his blasts displayed a marker generally considered unique to myeloid cells: they selectively bound the granulocyte chemotaxin N-formyl-Met-Leu-Phe. In addition, some cells contained granules resembling those of basophils or mast cells. Such mixed myeloid-lymphoid features in chronic myelogenous leukemia blast cells may reflect malignant transformation of a stem cell capable of both myeloid and lymphoid differentiation, or they may reflect the dedifferentiation as a feature of malignant change.
D000951:Antigens, Neoplasm / Q000276:immunology; D000970:Antineoplastic Agents / Q000008:administration & dosage; D002454:Cell Differentiation; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D002634:Chemotaxis, Leukocyte; D002904:Chromosomes, Human, 21-22 and Y / Q000648:ultrastructure; D004359:Drug Therapy, Combination; D006801:Humans; D007945:Leukemia, Lymphoid / Q000473:pathology*; D007951:Leukemia, Myeloid / Q000188:drug therapy / Q000276:immunology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009240:N-Formylmethionine Leucyl-Phenylalanine / Q000276:immunology; D014411:Neoplastic Stem Cells / Q000473:pathology; D010641:Phenotype
D000951:Antigens, Neoplasm; D000970:Antineoplastic Agents; D009240:N-Formylmethionine Leucyl-Phenylalanine