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Serefhanoglu, S. et al.

Songul Serefhanoglu, Hakan Goker, Yahya Buyukasik, Nilgun Sayinalp, Osman I. Ozcebe,

Transformation of adult myelodysplastic syndrome-refractory anemia to acute T-cell lymphoblastic leukemia.

OBJECTIVE: Myelodysplastic syndrome (MDS) is recognized as a preleukemic disorder with a variable risk of transformation to acute myeloid leukemia. Usually the blast cells in leukemia are transformed after MDS displays a myeloid phenotype. Lymphoid progression had been reported as myeloid-lymphoid hybrid or early B phenotype, but our patient transformed acute T-lymphoblastic leukemia, which is a rare lymphoid transformation. CLINICAL PRESENTATION AND INTERVENTION: We present a case of refractory anemia with excess of blast that transformed into acute T-cell lymphoblastic leukemia. MDS was diagnosed in a 69-year-old man in April 2007. Twelve month later, he developed T-acute lymphoblastic leukemia. The blasts were positive for expression of CD2, CD3, CD5, CD7, CD45, and HLA-DR, leading to a diagnosis of T-lymphoblastic leukemia. The patient was treated with chemotherapy, but he died of multiple organ failure. CONCLUSION: The mechanism of lymphoid transformation is not yet fully understood. This case clinically supports the nature of MDS as a pluripotent hematopoietic stem cell disorder. MDS often transforms into acute leukemia, usually of a myeloid phenotype. The transformation of MDS into acute lymphoblastic leukemia is extremely rare.[1]

References

Transformation of adult myelodysplastic syndrome-refractory anemia to acute T-cell lymphoblastic leukemia. Serefhanoglu, S., Goker, H., Buyukasik, Y., Sayinalp, N., Ozcebe, O.I. J. Natl. Med. Assoc (2009) [Pubmed]

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