Phenotypic and genotypic switch in Philadelphia-positive, BCR-positive blast crisis of chronic myeloid leukemia

V. Callea, F. Morabito, P. Francia Di Celle, F. Ronco, A. Carbone, F. Nobile, R. Foa

Research output: Contribution to journalArticle

Abstract

We report a case of Ph1-positive, bcr-positive chronic myeloid leukemia blast crisis (CML-BC) which at presentation showed a mixed myeloid/B-lymphoid immunophenotype along with TdT positivity and, at the molecular level, an oligoclonal rearrangement of the immunoglobulin heavy chain (IgH) gene region. After obtaining a successful remission, at the time of relapse the patient underwent a phenotypic and genotypic switch from mixed to myeloid phenotype, characterized by the loss of the lymphoid markers and TdT expression and by a germline configuration of the IgH gene region. The same bcr rearrangement was, however, found in both phases of the disease, supporting the suggestion of a true phenotypic and genotypic conversion. This report confirms that the neoplastic event in CML may take place at an early multipotent stem-cell level, prior to a well-defined phenotypic and genotypic lineage expression. Moreover, it is suggested that different factors (chemotherapy? growth factors?) may have either eradicated the bcr +/IgH + clone and promoted the growth of bcr +/IgH - leukemic cells or, alternatively, supported the lymphoid differentiation program and induced a myeloid lineage shift.

Original languageEnglish
Pages (from-to)187-191
Number of pages5
JournalEuropean Journal of Haematology
Volume48
Issue number4
Publication statusPublished - 1992

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Immunoglobulin Heavy Chain Genes
Blast Crisis
Immunoglobulin Heavy Chains
Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Oligoclonal Bands
Multipotent Stem Cells
Intercellular Signaling Peptides and Proteins
Clone Cells
Phenotype
Recurrence
Drug Therapy
Growth

ASJC Scopus subject areas

  • Hematology

Cite this

Callea, V., Morabito, F., Francia Di Celle, P., Ronco, F., Carbone, A., Nobile, F., & Foa, R. (1992). Phenotypic and genotypic switch in Philadelphia-positive, BCR-positive blast crisis of chronic myeloid leukemia. European Journal of Haematology, 48(4), 187-191.

Phenotypic and genotypic switch in Philadelphia-positive, BCR-positive blast crisis of chronic myeloid leukemia. / Callea, V.; Morabito, F.; Francia Di Celle, P.; Ronco, F.; Carbone, A.; Nobile, F.; Foa, R.

In: European Journal of Haematology, Vol. 48, No. 4, 1992, p. 187-191.

Research output: Contribution to journalArticle

Callea, V, Morabito, F, Francia Di Celle, P, Ronco, F, Carbone, A, Nobile, F & Foa, R 1992, 'Phenotypic and genotypic switch in Philadelphia-positive, BCR-positive blast crisis of chronic myeloid leukemia', European Journal of Haematology, vol. 48, no. 4, pp. 187-191.
Callea V, Morabito F, Francia Di Celle P, Ronco F, Carbone A, Nobile F et al. Phenotypic and genotypic switch in Philadelphia-positive, BCR-positive blast crisis of chronic myeloid leukemia. European Journal of Haematology. 1992;48(4):187-191.
Callea, V. ; Morabito, F. ; Francia Di Celle, P. ; Ronco, F. ; Carbone, A. ; Nobile, F. ; Foa, R. / Phenotypic and genotypic switch in Philadelphia-positive, BCR-positive blast crisis of chronic myeloid leukemia. In: European Journal of Haematology. 1992 ; Vol. 48, No. 4. pp. 187-191.
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