Chronic lymphocytic leukemia developing in a patient with chronic myeloid leukemia: Evidence of distinct lineage-associated genomic events

We describe the cytogenetic, fluorescence in situ hybridization (FISH), and molecular findings in a patient who developed a typical chronic lymphocytic leukemia (CLL) 20 months after the diagnosis of a Philadelphia (Ph)-positive chronic myeloid leukemia. Unstimulated bone marrow culture showed a 46,XX,t(9;22)(q34;q11) karyotype, and interphase FISH detected the presence of a BCR/ABL fusion signal in 13% of cells. On stimulated bone marrow culture, a normal karyotype and a 13q14 deletion by interphase FISH with D13S319 probe in 14% of the cells were found. Molecular studies detected the chimeric BCR/ABL messengers by nested reverse-transcriptase polymerase chain reaction. The B-cellular clone was documented by the presence of a clonal heavy chain inmunoglobulin rearrangement. The coexistence of these two hematologic malignancies leads to questions about their cell(s) of origin. We provide evidence that CLL arose in a Ph-negative clone. The implications of these findings are discussed. © 2005 Elsevier Inc. All rights reserved.Fil: Gargallo, Patricia Martha. Academia Nacional de Medicina de Buenos Aires; ArgentinaFil: Cacchione, Roberto. Centro de Estudios Médicos e Investigaciones Clínicas; ArgentinaFil: Chena, Christian. Academia Nacional de Medicina de Buenos Aires; ArgentinaFil: Dupont, Juan. Centro de Estudios Médicos e Investigaciones Clínicas; ArgentinaFil: Garay, Guy. Centro de Estudios Médicos e Investigaciones Clínicas; ArgentinaFil: Riveros, Dardo Alberto. Centro de Estudios Médicos e Investigaciones Clínicas; ArgentinaFil: Larripa, Irene Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Academia Nacional de Medicina de Buenos Aires; ArgentinaFil: Slavutsky, Irma Rosa. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Academia Nacional de Medicina de Buenos Aires; Argentin