Therapy-related acute lymphoblastic leukemia with t(4;11)(q21;q23) masqueraded as marrow lymphocytosis in a patient with breast cancer
Therapy-related acute leukemia develops in patients after chemotherapy and/or radiotherapy for a prior cancer, and most cases are acute myeloid leukemia with a much lower frequency of acute lymphoblastic leukemia (ALL). One unique feature of these therapy-related ALL (t-ALL) is an increased incidenc...
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| Format: | Article |
| Language: | English |
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Wiley
2012-03-01
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| Series: | Kaohsiung Journal of Medical Sciences |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1607551X11001471 |
| _version_ | 1819013072856023040 |
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| author | Yen-Hsun Chen Yen-Chuan Hsieh Shu-Hui Lin Szu-Yin Kuo Chiou-Ping Liu Wei-Shou Hwang Wen-Tsung Huang Yin-Hsun Feng Shih-Sung Chuang Ching-Nan Lin |
| author_facet | Yen-Hsun Chen Yen-Chuan Hsieh Shu-Hui Lin Szu-Yin Kuo Chiou-Ping Liu Wei-Shou Hwang Wen-Tsung Huang Yin-Hsun Feng Shih-Sung Chuang Ching-Nan Lin |
| author_sort | Yen-Hsun Chen |
| collection | DOAJ |
| description | Therapy-related acute leukemia develops in patients after chemotherapy and/or radiotherapy for a prior cancer, and most cases are acute myeloid leukemia with a much lower frequency of acute lymphoblastic leukemia (ALL). One unique feature of these therapy-related ALL (t-ALL) is an increased incidence of chromosome band 11q23 aberrations as compared with de novo ALL. In adult female patients, breast cancer is the most common primary cancer. Herein, we report the case of a 49-year-old Taiwanese lady who developed t-ALL with t(4;11)(q21;q23) 16 months after cyclophosphamide, epirubicin, and 5-fluorouracil chemotherapy for her breast cancer. The unusual feature is that the t-ALL was heralded 4 months ago by marrow lymphocytosis comprising atypical small lymphocytes with condensed chromatin mimicking a B-cell chronic lymphoproliferative disorder. Retrospective studies using additional antibodies for immunophenotyping and PCR-based clonality study for immunoglobulin gene rearrangement showed that these atypical small lymphocytes shared similar features with the leukemic blasts at the frank leukemic stage. Our results suggest that these atypical small lymphocytes are lymphoblasts in disguise and that the clinicopathological correlations with ancillary pathological studies are important to reach a definitive diagnosis of such an unusual case. |
| first_indexed | 2024-12-21T01:54:08Z |
| format | Article |
| id | doaj.art-d79d50766052436dbf6576fedb0fd40f |
| institution | Directory Open Access Journal |
| issn | 1607-551X |
| language | English |
| last_indexed | 2024-12-21T01:54:08Z |
| publishDate | 2012-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Kaohsiung Journal of Medical Sciences |
| spelling | doaj.art-d79d50766052436dbf6576fedb0fd40f2022-12-21T19:19:49ZengWileyKaohsiung Journal of Medical Sciences1607-551X2012-03-0128317317710.1016/j.kjms.2011.06.026Therapy-related acute lymphoblastic leukemia with t(4;11)(q21;q23) masqueraded as marrow lymphocytosis in a patient with breast cancerYen-Hsun Chen0Yen-Chuan Hsieh1Shu-Hui Lin2Szu-Yin Kuo3Chiou-Ping Liu4Wei-Shou Hwang5Wen-Tsung Huang6Yin-Hsun Feng7Shih-Sung Chuang8Ching-Nan Lin9Division of Hemato-Oncology, Department of Internal Medicine, Chi-Mei Liouying Hospital, Tainan, TaiwanDepartment of Pathology, Chi-Mei Medical Center, Tainan, TaiwanDepartment of Pathology, Chi-Mei Medical Center, Tainan, TaiwanDepartment of Pathology, Chi-Mei Medical Center, Tainan, TaiwanDepartment of Pathology, Chi-Mei Medical Center, Tainan, TaiwanDivision of Hemato-Oncology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, TaiwanDivision of Hemato-Oncology, Department of Internal Medicine, Chi-Mei Liouying Hospital, Tainan, TaiwanDivision of Hemato-Oncology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan, TaiwanDepartment of Pathology, Chi-Mei Medical Center, Tainan, TaiwanDepartment of Pathology, Chi-Mei Medical Center, Tainan, TaiwanTherapy-related acute leukemia develops in patients after chemotherapy and/or radiotherapy for a prior cancer, and most cases are acute myeloid leukemia with a much lower frequency of acute lymphoblastic leukemia (ALL). One unique feature of these therapy-related ALL (t-ALL) is an increased incidence of chromosome band 11q23 aberrations as compared with de novo ALL. In adult female patients, breast cancer is the most common primary cancer. Herein, we report the case of a 49-year-old Taiwanese lady who developed t-ALL with t(4;11)(q21;q23) 16 months after cyclophosphamide, epirubicin, and 5-fluorouracil chemotherapy for her breast cancer. The unusual feature is that the t-ALL was heralded 4 months ago by marrow lymphocytosis comprising atypical small lymphocytes with condensed chromatin mimicking a B-cell chronic lymphoproliferative disorder. Retrospective studies using additional antibodies for immunophenotyping and PCR-based clonality study for immunoglobulin gene rearrangement showed that these atypical small lymphocytes shared similar features with the leukemic blasts at the frank leukemic stage. Our results suggest that these atypical small lymphocytes are lymphoblasts in disguise and that the clinicopathological correlations with ancillary pathological studies are important to reach a definitive diagnosis of such an unusual case.http://www.sciencedirect.com/science/article/pii/S1607551X11001471Breast cancerClonality studyLymphocytosisTaiwanTherapy-related acute lymphoblastic leukemia |
| spellingShingle | Yen-Hsun Chen Yen-Chuan Hsieh Shu-Hui Lin Szu-Yin Kuo Chiou-Ping Liu Wei-Shou Hwang Wen-Tsung Huang Yin-Hsun Feng Shih-Sung Chuang Ching-Nan Lin Therapy-related acute lymphoblastic leukemia with t(4;11)(q21;q23) masqueraded as marrow lymphocytosis in a patient with breast cancer Kaohsiung Journal of Medical Sciences Breast cancer Clonality study Lymphocytosis Taiwan Therapy-related acute lymphoblastic leukemia |
| title | Therapy-related acute lymphoblastic leukemia with t(4;11)(q21;q23) masqueraded as marrow lymphocytosis in a patient with breast cancer |
| title_full | Therapy-related acute lymphoblastic leukemia with t(4;11)(q21;q23) masqueraded as marrow lymphocytosis in a patient with breast cancer |
| title_fullStr | Therapy-related acute lymphoblastic leukemia with t(4;11)(q21;q23) masqueraded as marrow lymphocytosis in a patient with breast cancer |
| title_full_unstemmed | Therapy-related acute lymphoblastic leukemia with t(4;11)(q21;q23) masqueraded as marrow lymphocytosis in a patient with breast cancer |
| title_short | Therapy-related acute lymphoblastic leukemia with t(4;11)(q21;q23) masqueraded as marrow lymphocytosis in a patient with breast cancer |
| title_sort | therapy related acute lymphoblastic leukemia with t 4 11 q21 q23 masqueraded as marrow lymphocytosis in a patient with breast cancer |
| topic | Breast cancer Clonality study Lymphocytosis Taiwan Therapy-related acute lymphoblastic leukemia |
| url | http://www.sciencedirect.com/science/article/pii/S1607551X11001471 |
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