A Pediatric Case of Adult Type Chronic Myelogenous Leukemia with a Complex Ph¹ Translocation and Peptic Ulcer

Abstract

A 10-year-old male patient with adult type chronic myelogenous leukemia is reported. The patient had a rare complex Ph¹ translocation, t (4; 18; 13; 9; 22) (q12; q11.2; q14; q34; q11.2) and had no splenomegaly at diagnosis. He developed several episodes of peptic ulcer during his six and a half year-long chronic phase, and eventually died 3 months later of acute blast crisis, unresponsive to chemotherapy (VCR/L-asp/Pred and BHAC/ACMA). Despite their low TdT activity, the blasts at crisis expressed CALLA and Ia-like antigen, were positive for PAS but not for peroxidase staining, and were classified as L1 by FAB conventions, suggesting of lymphoid lineage.