Extramedullary T lymphoid blast crisis representing an additional translocation, t(6;8)(q25;q22) in a patient with Philadelphia-positive chronic myelogenous leukemia after allogeneic bone marrow transplantation

Okazuka, Kiyoshi; Toba, Ken; Kawai, Kazuhiro; Nikkuni, Koji; Tsuchiyama, Junjiro; Momoi, Akihito; Kanazawa, Naoko; Nagai, Koich; Suzuki, Noriatsu; Aizawa, Yoshifusa

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Volume 25, Issue 12 , Pages 1089-1094, December 2001

Extramedullary T lymphoid blast crisis representing an additional translocation, t(6;8)(q25;q22) in a patient with Philadelphia-positive chronic myelogenous leukemia after allogeneic bone marrow transplantation

Kiyoshi Okazuka
- First Department of Internal Medicine, Niigata University School of Medicine, Asahimachi-dori 1, Niigata City 951-8520, Japan
Ken Toba
- First Department of Internal Medicine, Niigata University School of Medicine, Asahimachi-dori 1, Niigata City 951-8520, Japan
- Corresponding author. Tel.: +81-25-2272185; fax: +81-25-2270774
Kazuhiro Kawai
- Department of Dermatology, Niigata University School of Medicine, Asahimachi-dori 1, Niigata City 951-8520, Japan
Koji Nikkuni
- First Department of Internal Medicine, Niigata University School of Medicine, Asahimachi-dori 1, Niigata City 951-8520, Japan
Junjiro Tsuchiyama
- First Department of Internal Medicine, Niigata University School of Medicine, Asahimachi-dori 1, Niigata City 951-8520, Japan
Akihito Momoi
- First Department of Internal Medicine, Niigata University School of Medicine, Asahimachi-dori 1, Niigata City 951-8520, Japan
Naoko Kanazawa
- First Department of Internal Medicine, Niigata University School of Medicine, Asahimachi-dori 1, Niigata City 951-8520, Japan
Koich Nagai
- Department of Internal Medicine, Niigata Prefectural Central Hospital, Joetsu City, Japan
Noriatsu Suzuki
- Department of Internal Medicine, Niigata Prefectural Central Hospital, Joetsu City, Japan
Yoshifusa Aizawa
- First Department of Internal Medicine, Niigata University School of Medicine, Asahimachi-dori 1, Niigata City 951-8520, Japan

Received 8 January 2001; accepted 5 April 2001.

Abstract

A patient with extramedullary crisis from chronic myelogenous leukemia after allogeneic bone marrow transplantation is reported. A pathological neck lymph node observed after transplantation revealed pre-T lymphoblastic phenotype, and the fluorescence in situ hybridization (FISH) analysis showed recipient type sex chromosomes and bcr/abl fusion gene. The cells represented an additional translocation, t(6;8)(q25;q22). No rearrangements of the T-cell receptor (TCR) β, γ or δ chain genes were observed. The absence of TCR rearrangement indicated the clonogenic involvement of pluripotent hematopoietic stem cells by Philadelphia chromosome. Bone marrow specimens at that time showed donor type sex chromosomes and no bcr/abl-positive cells by FISH.

Keywords: Chronic myelogenous leukemia, T-Lymphoblastic crisis, Extramedullary crisis, Chromosome translocation, Bone marrow transplantation

Abbreviations: ALL, acute lymphoblastic leukemia, BC, blast crisis, BMT, bone marrow transplantation, CML, chronic myelogenous leukemia, CP, chronic phase, EBV, Epstein–Barr virus, FISH, fluorescence in situ hybridization, FITC, fluorescein isothiocyanate, LBL, lymphoblastic lymphoma, PE, phycoerythrin, Ph, Philadelphia, TCR, T-cell receptor, TdT, terminal deoxynucleotidyl transferase