Acute leukemia is an untoward event following immunosuppression for solid organ transplantation and is related to the oncogenic effects of Epstein-Barr viral infections. The authors report a case of acute, Philadelphia chromosome–positive, T-cell lymphoblastic leukemia following liver transplantation. Molecular typing demonstrated a minor bcr-abl rearrangement (190 kD), which persisted in remission in 71% of peripheral neutrophils as determined by fluorescence in situ hybridization. The authors conclude that this patient may have presented in a lymphoid blast crisis of chronic myelogenous leukemia with an acute T-cell leukemia/lymphoma syndrome.
From Bonfils Blood Center (C.C.S.), the Departments of Pediatrics (C.C.S.), Surgery (F.G.K.), and Molecular Biology (L.M.), the University of Colorado School of Medicine, Denver, Colorado, U.S.A.; the Department of Pathology (Q.W.), the Division of Hematology/Oncology (M.B.), The Children's Hospital, Denver, Colorado, U.S.A.; the Department of Pathology (R.W.T.), Presbyterian St. Luke's Hospital and the Bone Marrow Transplant Program (S.M.D.), University of Minnesota, Minneapolis, Minnesota, U.S.A.
Submitted for publication August 12, 2002; accepted December 19, 2002.
Supported by Bonfils Blood Center, a Clinical Associate Physician Award (#M01-RR00069) from the General Clinical Resources Center National Center for Research Resources, NIH and grant #HL59355 from NHLBI, NIH.
Address correspondence and reprint requests to Christopher C. Silliman, M.D., Ph.D., Associate Medical Director, Bonfils Blood Center, 717 Yosemite Circle, Denver, CO 80220, U.S.A. E-mail: firstname.lastname@example.org.