Myeloid/natural killer cell blast crisis representing an additional translocation, t(3;7)(q26;q21) in Philadelphia-positive chronic myelogenous leukemia.
We encountered a patient in blast crisis (BC) with chronic myelogenous leukemia (CML) who showed immunophenotypic features similar to those previously described in acute myeloid/natural killer (NK) cell precursor leukemia. The blasts were positive for CD7, CD33, CD34, and CD56. Cytogenetic analysis disclosed a Philadelphia chromosome (Ph) and t(3;7)(q26;q21). Molecular analysis did not detect any EVI1/CDK6 chimeric transcript generated by t(3;7)(q26;q21), but did indicate overexpression of EVI1, which occurs frequently in progression to myeloid BC in CML. Three cases of myeloid/NK cell precursor BC in CML have been reported, but this case is the first to present with Ph and EVI1 abnormality. These observations suggested that a myeloid/NK cell precursor might have been involved in the Ph-positive clone and have been a target for blastic transformation of CML, although EVI1 expression is not specific for transformation to BC from myeloid/NK lineage.
Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
Hideho
H
Henzan
Goichi
G
Yoshimoto
Aki
A
Okeda
Yoji
Y
Nagasaki
Gen
G
Hirano
Ken
K
Takase
Tetsuya
T
Tanimoto
Toshihiro
T
Miyamoto
Takahiro
T
Fukuda
Koji
K
Nagafuji
Mine
M
Harada
D000293:Adolescent; D015703:Antigens, CD / Q000096:biosynthesis; D001752:Blast Crisis / Q000235:genetics / Q000473:pathology*; D019070:Cell Lineage / Q000235:genetics; D002893:Chromosomes, Human, Pair 3 / Q000235:genetics*; D002897:Chromosomes, Human, Pair 7 / Q000235:genetics*; D004268:DNA-Binding Proteins / Q000096:biosynthesis; D006801:Humans; D007694:Killer Cells, Natural / Q000378:metabolism / Q000473:pathology*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D008213:Lymphocyte Activation / Q000235:genetics; D000074008:MDS1 and EVI1 Complex Locus Protein; D008297:Male; D010677:Philadelphia Chromosome; D011519:Proto-Oncogenes; D014157:Transcription Factors / Q000096:biosynthesis
D015703:Antigens, CD; D004268:DNA-Binding Proteins; D000074008:MDS1 and EVI1 Complex Locus Protein; C063575:MECOM protein, human; D014157:Transcription Factors