Skip to main content
SpringerLink
Log in

B-acute lymphoblastic leukemia/lymphoma (B-ALL) with precedent or concurrent myelodysplastic syndrome (MDS) with deletion 5q

  • Case Report
  • Published:
Journal of Hematopathology Aims and scope Submit manuscript

Abstract

Progression to acute leukemia is an inherited feature of myelodysplastic syndrome (MDS). While majority of acute leukemia cases in this setting is acute myeloid leukemia (AML), rare cases of acute B-lymphoblastic leukemia/lymphoma (B-ALL) also exist. Therefore, detection of increased blasts in a patient with MDS should not be equated with a diagnosis of AML; full immunophenotyping of blasts is required. Previous reports indicate that dysplastic myeloid cells and B-lymphoblasts belong to the same clone. However, dysplastic myeloid cells and B-lymphoblasts could be clonally unrelated. Decitabine in addition to hyperCVAD (fractionated cyclophosphamide, vincristine, doxorubicin and dexamethasone alternating with high-dose methotrexate and cytarabine) could be a good treatment option in this particular clinical setting.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM, Bloomfield CD, Cazzola M, Vardiman JW (2016) The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood 127(20):2391–2405. https://doi.org/10.1182/blood-2016-03-643544

    Article  CAS  PubMed  Google Scholar 

  2. Ok CY, Patel KP, Garcia-Manero G, Routbort MJ, Peng J, Tang G, Goswami M, Young KH, Singh R, Medeiros LJ, Kantarjian HM, Luthra R, Wang SA (2015) TP53 mutation characteristics in therapy-related myelodysplastic syndromes and acute myeloid leukemia is similar to de novo diseases. J Hematol Oncol 8:45. https://doi.org/10.1186/s13045-015-0139-z

    Article  PubMed  PubMed Central  Google Scholar 

  3. Ok CY, Leventaki V, Wang SA, Dinardo C, Medeiros LJ, Konoplev S (2016) Detection of an abnormal myeloid clone by flow Cytometry in familial platelet disorder with propensity to myeloid malignancy. Am J Clin Pathol 145(2):271–276. https://doi.org/10.1093/ajcp/aqv080

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Tang Z, Medeiros LJ, Yin CC, Wang W, Lu X, Young KH, Khoury JD, Tang G (2016) Sex chromosome loss after allogeneic hematopoietic stem cell transplant in patients with hematologic neoplasms: a diagnostic dilemma for clinical cytogeneticists. Mol Cytogenet 9:62. https://doi.org/10.1186/s13039-016-0275-3

    Article  PubMed  PubMed Central  Google Scholar 

  5. McGowan-Jordan J, Simons A, Schmid M (2016) ISCN: an international system for human Cytogenomic nomenclature (2016). Karger, Basel

    Book  Google Scholar 

  6. Gu J, Patel KP, Bai B, Liu CH, Tang G, Kantarjian HM, Tang Z, Abraham R, Luthra R, Medeiros LJ, Lin P, Lu X (2015) Double inv(3) (q21q26.2) in acute myeloid leukemia is resulted from an acquired copy neutral loss of heterozygosity of chromosome 3q and associated with disease progression. Mol Cytogenet 8:68. https://doi.org/10.1186/s13039-015-0171-2

    Article  PubMed  PubMed Central  Google Scholar 

  7. Algarni AA, Akhtari M, Fu K (2012) Myelodysplastic syndrome with myelofibrosis transformed to a precursor B-cell acute lymphoblastic leukemia: a case report with review of the literature. Case Rep Hematol 2012:207537. https://doi.org/10.1155/2012/207537

    PubMed  PubMed Central  Google Scholar 

  8. Abruzzese E, Buss D, Rainer R, Pettenati MJ, Rao PN (1996) Progression of a myelodysplastic syndrome to pre-B acute lymphoblastic leukemia: a case report and cell lineage study. Ann Hematol 73(1):35–38

    Article  CAS  PubMed  Google Scholar 

  9. Disperati P, Ichim CV, Tkachuk D, Chun K, Schuh AC, Wells RA (2006) Progression of myelodysplasia to acute lymphoblastic leukaemia: implications for disease biology. Leuk Res 30(2):233–239. https://doi.org/10.1016/j.leukres.2005.06.011

    Article  CAS  PubMed  Google Scholar 

  10. Sato N, Nakazato T, Kizaki M, Ikeda Y, Okamoto S (2004) Transformation of myelodysplastic syndrome to acute lymphoblastic leukemia: a case report and review of the literature. Int J Hematol 79(2):147–151

    Article  PubMed  Google Scholar 

  11. Follows GA, Owen RG, Ashcroft AJ, Parapia LA (1999) Eosinophilic myelodysplasia transforming to acute lymphoblastic leukaemia. J Clin Pathol 52(5):388–389

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Koh YR, Cho EH, Park SS, Park MY, Lee SM, Kim IS, Lee EY (2013) A rare case of transformation of childhood myelodysplastic syndrome to acute lymphoblastic leukemia. Ann Lab Med 33(2):130–135. https://doi.org/10.3343/alm.2013.33.2.130

    Article  PubMed  PubMed Central  Google Scholar 

  13. Zainina S, Cheong SK (2006) Myelodysplastic syndrome transformed into acute lymphoblastic leukaemia (FAB:L3). Clin Lab Haematol 28(4):282–283. https://doi.org/10.1111/j.1365-2257.2006.00800.x

    Article  CAS  PubMed  Google Scholar 

  14. Gupta V, Bhatia B (2010) Transformation of myelodysplastic syndrome to acute lymphoblastic leukemia in a child. Indian J Hematol Blood Transfus 26(3):111–113. https://doi.org/10.1007/s12288-010-0015-5

    Article  PubMed  PubMed Central  Google Scholar 

  15. Goel R, Kumar R, Bakhshi S (2007) Transformation of childhood MDS-refractory anemia to acute lymphoblastic leukemia. J Pediatr Hematol Oncol 29(10):725–727. https://doi.org/10.1097/MPH.0b013e31814d6959

    Article  PubMed  Google Scholar 

  16. Agostino NM, Ahmed B, Popescu D, Gheith S (2011) Transformation of the 5q- syndrome to acute lymphoblastic leukemia: a report of two cases and review of the literature. Int J Clin Exp Pathol 4(3):322–326

    PubMed  PubMed Central  Google Scholar 

  17. Gaballa MR, Besa EC (2014) Myelodysplastic syndromes with 5q deletion: pathophysiology and role of lenalidomide. Ann Hematol 93(5):723–733. https://doi.org/10.1007/s00277-014-2022-3

    Article  CAS  PubMed  Google Scholar 

  18. Min IM, Pietramaggiori G, Kim FS, Passegue E, Stevenson KE, Wagers AJ (2008) The transcription factor EGR1 controls both the proliferation and localization of hematopoietic stem cells. Cell Stem Cell 2(4):380–391. https://doi.org/10.1016/j.stem.2008.01.015

    Article  CAS  PubMed  Google Scholar 

  19. Jadersten M, Saft L, Smith A, Kulasekararaj A, Pomplun S, Gohring G, Hedlund A, Hast R, Schlegelberger B, Porwit A, Hellstrom-Lindberg E, Mufti GJ (2011) TP53 mutations in low-risk myelodysplastic syndromes with del(5q) predict disease progression. J Clin Oncol 29(15):1971–1979. https://doi.org/10.1200/JCO.2010.31.8576

    Article  PubMed  Google Scholar 

  20. Langemeijer SM, Jansen JH, Hooijer J, van Hoogen P, Stevens-Linders E, Massop M, Waanders E, van Reijmersdal SV, Stevens-Kroef MJ, Zwaan CM, van den Heuvel-Eibrink MM, Sonneveld E, Hoogerbrugge PM, van Kessel AG, Kuiper RP (2011) TET2 mutations in childhood leukemia. Leukemia 25(1):189–192. https://doi.org/10.1038/leu.2010.243

    Article  CAS  PubMed  Google Scholar 

  21. Schafer V, Ernst J, Rinke J, Winkelmann N, Beck JF, Hochhaus A, Gruhn B, Ernst T (2016) EZH2 mutations and promoter hypermethylation in childhood acute lymphoblastic leukemia. J Cancer Res Clin Oncol 142(7):1641–1650. https://doi.org/10.1007/s00432-016-2174-8

    Article  PubMed  Google Scholar 

  22. Benton CB, Thomas DA, Yang H, Ravandi F, Rytting M, O'Brien S, Franklin AR, Borthakur G, Dara S, Kwari M, Pierce SR, Jabbour E, Kantarjian H, Garcia-Manero G (2014) Safety and clinical activity of 5-aza-2′-deoxycytidine (decitabine) with or without hyper-CVAD in relapsed/refractory acute lymphocytic leukaemia. Br J Haematol 167(3):356–365. https://doi.org/10.1111/bjh.13050

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea

    Jin Woo Joo

  2. Department of Hematopathology, The University of Texas, M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030-4009, USA

    Sergej Konoplev, Timothy J. McDonnell & Chi Young Ok

Authors
  1. Jin Woo Joo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sergej Konoplev
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Timothy J. McDonnell
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chi Young Ok
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chi Young Ok.

Ethics declarations

Conflict of interest

Author Jin Woo Joo, Author Sergej Konoplev, Author Timothy J. McDonnell and Author Chi Young Ok declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Joo, J.W., Konoplev, S., McDonnell, T.J. et al. B-acute lymphoblastic leukemia/lymphoma (B-ALL) with precedent or concurrent myelodysplastic syndrome (MDS) with deletion 5q. J Hematopathol 10, 75–80 (2017). https://doi.org/10.1007/s12308-017-0298-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12308-017-0298-7

Keywords

Search

Navigation