T-lineage blast crisis of chronic myelogenous leukemia: simple record of 4 cases
Abstract: Blast crisis (BC)
transformation in chronic myelogenous leukemia (CML) can involve each
differentiation lineage of the hematopoietic system, i.e. granulocyte,
monocyte, erythrocyte, megakaryocyte, and lymphocyte lineage. The lymphoid
blast crisis (BC) leukemia cells usually belong to B-lineage, commonly having
the phenotype of Pre-B stage of the B-lineage, in which cell-surface
immunoglobulin (sIg) is not yet expressed. In contrast, T-lineage BC of CML is
extremely rare. The objective of this study is to describe the fenotype, fusion
transcript of bcr-abl, TdT, and cytoplasmic CD3 in T-lineage BC CML cases. Case
report study. This report shows a simple summary of 4 cases of T-lineage BC of
CML which have been collected in the phenotypic and genotypic analysis study
for 17 years (1987-2004). In all cases, the chromosomal analysis revealed the
presence of t(9;22)(q34;q11) at presentation. Cell surface analysis were done
at diagnosis. Cases’ mononuclear cells stored as 10% DMSO were retrieved to be
performed reverse transcription (RT) PCR BCR-ABL multiplex to demonstrate the
presence of the fusion transcript of bcr-abl. RT-PCR was also performed for
detecting the expression of cytoplasmic CD3ε and terminal deoxynucleotydil
transferase (TdT). The results of cell surface antigen (CSA) at presentation
showed that 1 case was CD7+, CD5-, and CD2-; 1 case CD7+, CD5+, and CD2-; and 2
cases CD7+, CD5+ and CD2+ indicating that all these T-lineage BC of CML cells
show the phenotype of pre-(pro-) thymic stage phenotype. In the present study,
two cases showed b2a2, one e1a2, and one negative bcr-abl transcript. The
RT-PCR revealed the presence of CD3ε mRNA in all cases, and TdT mRNA in only
one case. These results can constitute a basis for the future analysis of
T-lineage BC of CML from now on.
Keywords: chronic myelogenous
leukemia (CML), blastic crisis (BC), T-lineage, bcr-abl fusion gene, CDε, TdT
Author: Kartika W.
Taroeno-Hariadi, Eiji Tatsumi, Mardiah S. Hardianti, Kaho Furuta, Meilani
Syampurnawati, Bambang Karsono, Takayuki Ishikawa, Hiroki Yabe, Ken-Ichi Nagai,
Takayuki Takahashi, Yuji Kishimoto
Journal Code: jpkedokterangg050129
