Megakaryocytic blast crisis as a first presentation of chronic myeloid leukemia

dc.contributor.authorPelloso, Luis Arthur Flores [UNIFESP]
dc.contributor.authorBaiocchi, Otavio Carvalho Guimarães [UNIFESP]
dc.contributor.authorChauffaille, Maria de Lourdes Lopes Ferrari [UNIFESP]
dc.contributor.authorYamamoto, Mihoko [UNIFESP]
dc.contributor.authorHungria, VTM
dc.contributor.authorBordin, Jose Orlando [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionFac Ciencias Med Santa Casa Misericordia
dc.date.accessioned2018-06-15T17:22:27Z
dc.date.available2018-06-15T17:22:27Z
dc.date.issued2002-07-01
dc.description.abstractAcute megakaryocytic leukemia (AmegL) corresponds to 5.0-10.0% of all acute myeloid leukemias (AML). Blast crisis as the first presentation of chronic myeloid leukemia (CML) accounts for 10.0% of all cases. Objective: We report a case of megakaryocytic blast crisis as the first presentation of CML. Case report: A 25-yr-old-female with a 2-month history of dry cough and a large, non-tender splenomegaly was found to have a hemoglobin concentration of 10.5 g/dL, a hematocritof 33.0%, a white blood cell count (WBC) of 11.4 x 10(6) L with 38% small blasts, eosinophilia of 5%, basophilia of 8%, and a platelet count of 580 x 10(9) L. Bone marrow aspiration revealed 24% of blast cells with cytoplasmatic blebs and hyperplastic megakaryocytic lineage with dysplasia. Cytochemical stains were all negative, immunophenotyping studies showed CD41 and CD61 positivity in blast cells. Bone marrow biopsy showed grade II fibrosis. Karyotype revealed 46, XX, t(9,22) (q34.1;q11.2)[20] and the reverse-transcriptase-PCR (RT-PCR) gave rise a product with a size corresponding to the 210 kDa protein (p210). No matched donor was found. After induction therapy 5.9% of blast cells persisted. The patient received Imatinib Mesylate and is doing well after a 12-month follow-up. Discussion: AmegL as the first presentation of CML is a rare and often fatal event. Some characteristics point towards the diagnosis of a blast crisis instead of AmegL de novo with t(9,22).en
dc.description.affiliationUniv Fed Sao Paulo, Disciplina Hematol & Hemoterapia, EPM, BR-04023900 Sao Paulo, Brazil
dc.description.affiliationFac Ciencias Med Santa Casa Misericordia, Sao Paulo, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Disciplina Hematol & Hemoterapia, EPM, BR-04023900 Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent58-61
dc.identifierhttps://doi.org/10.1034/j.1600-0609.2002.01638.x
dc.identifier.citationEuropean Journal Of Haematology. Copenhagen: Blackwell Munksgaard, v. 69, n. 1, p. 58-61, 2002.
dc.identifier.doi10.1034/j.1600-0609.2002.01638.x
dc.identifier.issn0902-4441
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/43611
dc.identifier.wosWOS:000178084500010
dc.language.isoeng
dc.publisherBlackwell Munksgaard
dc.relation.ispartofEuropean Journal Of Haematology
dc.rightsAcesso restrito
dc.subjectacute megakaryocytic leukemiaen
dc.subjectblast crisisen
dc.subjectchronic myeloid leukemiaen
dc.titleMegakaryocytic blast crisis as a first presentation of chronic myeloid leukemiaen
dc.typeArtigo
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