Abstract
Secondary acute lymphoblastic leukemia (ALL) is a rare disease that has not been well characterized compared with secondary myelodysplastic syndrome or secondary acute myeloid leukemia. We present a report of two patients who developed ALL following complete remission of diffuse large B-cell lymphoma (DLBCL). The first case is more consistent with a therapy- related ALL as a PCR analysis of bone marrow aspirate revealed a distinct clone and the mixed-lineage leukemia gene rearrangement, commonly associated with exposure to topoisomerase II inhibitors. The second case is more consistent with clonal evolution given positive MYC and BCL2 fusion signals in the original diagnosis of DLBCL and the secondary ALL.
Highlights
The second patient was a 58-year-old female with past medical history of basal merase II inhibitors is characterized by a bone marrow aspirate and revealed a differ- cell carcinoma who originally presented shorter latency period and rearrangements at 11q23.3,4 In biopsy done at original diffuse large B-cell lymphoma (DLBCL) diagnosis. neck in September of 2015
Lymph node comparison to sAML and secondary At the time of acute lymphoblastic leukemia (ALL) diagnosis, the patient biopsy revealed grade 2 follicular lymmyelodysplasia, secondary acute was asymptomatic with normal complete phoma with predominately (60-70%) folliclymphoblastic leukemia is rare, and blood count and negative cerebrospinal ular architecture and zones of intrafollicular has not been well characterized
Discussion sALL is a uncommon disease that has been reported to account for 2-10% of all cases of ALL.[5,6,7,8,9]
Summary
SALL is a uncommon disease that has been reported to account for 2-10% of all cases of ALL.[5,6,7,8,9] Due its rarity and often underrecognition, the cytogenetic, molecular, and disease characteristics have not been as well-characterized as sMDS and sAML. There are two other reports in the literature of patients with DLBCL, and even multiple myeloma, that relapsed as ALL.[16,17,18] In one study, molecular analysis of the immunoglobulin heavy-chain gene showed that the initial lymphoma and its relapse were clonally related.[16] more common in indolent lymphomas, DLBCL has been rarely shown to present or progress to a leukemic phase with mature B cells in the peripheral blood, but this is distinct from our presentation of patients with a lymphoblastic phenotype.[19,20]. Hematologic malignancy sequencing panel was positive for mutations in Cyclin is well known that patients with an original presentation of DLBCL or ALL often
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
