title: Chronic myeloid leukemia as a secondary malignancy after lymphoma in a child. A case report and review of the literature.
abstract: BACKGROUND
  Philadelphia chromosome-positive chronic myeloid leukemia (CML) in children is very rare. CML occurring as a secondary malignancy in individuals treated for diffuse large B-cell lymphoma (DLBCL) is also rare.
  
  
  METHODS
  We present the case of a 5-year-old female patient who developed a right orbital mass that was diagnosed as DLBCL. 9 months after receiving treatment for DLBCL, she presented with a white cell count of 250,000/mm(3). Peripheral blood and bone marrow (BM) evaluation revealed a myeloproliferative disorder. Cytogenetic and molecular studies demonstrated the presence of t(9;22). CML following DLBCL has not been previously described in the younger population. To our knowledge, this is the first report of a child who developed a CML as a second malignancy after DLBCL. Therapy-related CML and non-therapy-related secondary CML are discussed as potential explanations of this highly unusual clinical presentation.
  
  
  CONCLUSIONS
  Hematological disorders such as CML may occur after lymphomas. With the increased use of BM cytogenetic studies during staging for lymphoid malignancies, future studies may be able to clarify the question of whether the CML clone in some of these patients existed before treatment for lymphoma.
authors.affiliation: Department of Clinical Hematology, Farhat Hached University Hospital Sousse-Tunisia, Tunisia. Kmira_zahra@yahoo.fr
authors.forename: Kmira
authors.initials: K
authors.lastname: Zahra
authors.forename: Wafa
authors.initials: W
authors.lastname: Ben Fredj
authors.forename: Yosra
authors.initials: Y
authors.lastname: Ben Youssef
authors.forename: Houneida
authors.initials: H
authors.lastname: Zaghouani
authors.forename: Imène
authors.initials: I
authors.lastname: Chebchoub
authors.forename: Monia
authors.initials: M
authors.lastname: Zaier
authors.forename: Sriha
authors.initials: S
authors.lastname: Badreddine
authors.forename: Nejia
authors.initials: N
authors.lastname: Braham
authors.forename: Hlima
authors.initials: H
authors.lastname: Sennana
authors.forename: Abderrahim
authors.initials: A
authors.lastname: Khelif
mesh_terms: D002675:Child, Preschool; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000175:diagnosis*; D008223:Lymphoma / Q000175:diagnosis*; D016609:Neoplasms, Second Primary / Q000175:diagnosis*