Acute Basophilic Leukemia Arising from Chronic Myeloid Leukemia with +8, I(17q)(q10) and der(22)t(9;22) After Imatinib Therapy

Abstract

Acute basophilic leukemia (ABL) arising from chronic myeloid leukemia (CML) with abundant mast cells (MCs), coexisting with a complex karyotype is rare. Here, we report an 81-year-old man admitted to our hospital with a history of ABL. He was diagnosed with CML in the chronic phase in January 2018, and Imatinib was used at a daily dose of 400mg. Then, transformation to ABL with abundant MCs in the bone marrow and complex karyotypes including 48,XY, trisomy 8 (+8), isochromosome 17(q10) [i(17)(q10)], and derivative chromosome 22 t(9;22) [der(22)t(9;22)] were discovered simultaneously in January 2022. In conclusion, the increased number of MCs in our case is a reminder that they might play an important role in the prognosis of CML and trigger the development of complex karyotypes. Moreover, this is the first case report of ABL arising from CML with abundant MCs, coexisting with 48,XY, +8, i(17)(q10), and der(22)t(9;22), during Imatinib treatment. Further studies are needed to better characterize this rare condition.

Keywords:

• CML
• TKIs
• MCs
• ABL
• complex karyotype

Data Sharing Statement

All authors have declared the datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Ethics Approval and Informed Consent

This study complies with all relevant ethical regulations and the study protocol was approved by the Biomedical Ethics Committee of USTC (2022-RE-335). The specimens of paraffin sections used in this study were obtained in previous clinical diagnosis and treatment, which will not cause physical and mental suffering to the patient. Written informed consent has been provided by the patient to have the case details, including photographs, case history and details published. The privacy and personal information of the patient will be protected, and the specimens that subjects have explicitly refused to use will not be used.

Acknowledgments

We are grateful to Dr Hang Dong for the diagnosis of peripheral blood and bone marrow smear. We also thank the department of Flow Cytometry and the central laboratory of the First Affiliated Hospital of USTC for their work in the diagnosis of this case.

Author Contributions

We thank Peng Shan and Shilan Li for made a significant contribution to the work reported. All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. All the authors declare that there is no conflict of interest.