T-cell blast crisis in chronic myelogenous leukemia. Immunophenotypic and molecular biologic findings

Am J Clin Pathol. 1997 Feb;107(2):168-76. doi: 10.1093/ajcp/107.2.168.

Abstract

T-cell blast crisis in chronic myelogenous leukemia is rare. We examined three patients (ages 35 to 72 years) in whom T-cell blast crisis developed 11 to 36 months (mean, 25 months) after diagnosis of chronic myelogenous leukemia and who died 4 to 12 months (mean, 7 months) thereafter. Two patients had diffuse lymphadenopathy, and the third had marked lymphocytosis (white blood cell count 217,000/microL, with 90% circulating blasts). In all three patients, neoplastic cells had the appearance of lymphoblasts and were immunoreactive for T-cell markers by immunohistochemical or flow cytometric analysis or both. Molecular diagnostic studies revealed the presence of a bcr-abl oncogene rearrangement in all three cases, but none exhibited a clonal T-cell receptor delta, beta, or gamma chain gene rearrangement. One case exhibited deletion of the J delta 1 region of both delta chain genes. The significance of these findings is discussed, and they are compared with those of other reported cases of T-cell blast crisis in chronic myelogenous leukemia.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aged
  • Biopsy
  • Blast Crisis / etiology
  • Blast Crisis / pathology*
  • Fatal Outcome
  • Female
  • Flow Cytometry
  • Fusion Proteins, bcr-abl / genetics
  • Humans
  • Immunohistochemistry
  • Immunophenotyping
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / etiology
  • Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology*
  • Lymph Nodes / chemistry
  • Lymph Nodes / pathology
  • Lymphocyte Activation*
  • Male
  • T-Lymphocytes / pathology*

Substances

  • Fusion Proteins, bcr-abl