Diagnostic challenges of de novo acute leukemia with positive BCR-ABL1 fusion: Case report and review of literature

Abstract

A 32-year-old female was admitted because of an acute course of gum bleeding and fatigability. On complete blood cell counts, bicytopenia was evident. Morphologic evaluation of the peripheral blood smear and bone marrow materials revealed remarkable involvement by two separate blastic populations (myeloid/B-cell lymphoid). Karyotyping, fluorescence in situ hybridization, and molecular analysis showed positive Philadelphia chromosome and BCR-ABL1 (p210) fusion. chronic myeloid leukemia in blast phase (CML-BP) versus mixed phenotype acute leukemia was critically debated as to which the final diagnosis should be assigned.

Keywords

• acute leukemia
• bcr-abl1 + acute leukemia
• blastic crisis
• chronic myeloid leukemia
• mixed phenotype acute leukemia