FISH study:
Diagnosis: CML with CNS B-ALL transformation.
CML:
•Clonal myeloproliferative disorder
–Characterized by t(9;22)(q34;q11)
•1-3% of childhood leukemia
•Phases
–Chronic (<5-10% blasts and no other progression features)
–Accelerated (10-19% blasts; unresponsive leucocytosis, thrombocytosis or thrombocytopenia; cytogenetic evolution; >=20% basophils in PB)
–Blast
•Over 20% blasts in blood or marrow or extramedullary disease
•Myeloid (80%)
–Duplication of Ph+ chrom; tri 8,19, or 21; i(17q), t(7;11); AML specific rearrangements
•Lymphoid (15-20%)
–B>T lineage; Ph+ duplication; tri 21; inv(7); t(14;14)
•Multilineage; erythrocytic; megakaryoblastic; mast cell crisis
CML:
•Clonal myeloproliferative disorder
–Characterized by t(9;22)(q34;q11)
•1-3% of childhood leukemia
•Phases
–Chronic (<5-10% blasts and no other progression features)
–Accelerated (10-19% blasts; unresponsive leucocytosis, thrombocytosis or thrombocytopenia; cytogenetic evolution; >=20% basophils in PB)
–Blast
•Over 20% blasts in blood or marrow or extramedullary disease
•Myeloid (80%)
–Duplication of Ph+ chrom; tri 8,19, or 21; i(17q), t(7;11); AML specific rearrangements
•Lymphoid (15-20%)
–B>T lineage; Ph+ duplication; tri 21; inv(7); t(14;14)
•Multilineage; erythrocytic; megakaryoblastic; mast cell crisis