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Philadelphia Chromosome–positive Acute Lymphoblastic Leukemia or Chronic Myeloid Leukemia in Lymphoid Blast Crisis

Kolenova, Alexandra MD, PhD; Maloney, Kelly W. MD; Hunger, Stephen P. MD

Journal of Pediatric Hematology/Oncology: August 2016 - Volume 38 - Issue 6 - p e193–e195
doi: 10.1097/MPH.0000000000000582
Online Articles: Clinical and Laboratory Observations
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The clinical characteristics of chronic myeloid leukemia (CML) in lymphoid blast crisis (BC) can resemble those of Philadelphia chromosome–positive acute lymphoblastic leukemia (Ph+ ALL). Because of this, there can be concern as to whether a patient with newly diagnosed Ph+ leukemia has Ph+ ALL or CML in lymphoid BC. This distinction has significant potential therapeutic implications because most children with Ph+ ALL are now treated with chemotherapy plus a tyrosine kinase inhibitor, whereas allogeneic stem cell transplant is usually recommended for any patient with CML that presents in or later develops BC.

*Department of Pediatric Hematology and Oncology, Comenius University Medical School and University Children’s Hospital, Bratislava, Slovak Republic

Pediatric Hematology/Oncology/BMT, University of Colorado School of Medicine and Children’s Hospital Colorado, Aurora, CO

Department of Pediatrics and the Center for Childhood Cancer Research, Children’s Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA

The authors declare no conflict of interest.

Reprints: Alexandra Kolenova, MD, PhD, Department of Pediatric Hematology and Oncology, Comenius University Medical School and University Children’s Hospital, Limbova 1, 833 40 Bratislava, Slovak Republic (e-mail: sasa.kolenova@gmail.com).

Received November 28, 2015

Accepted March 27, 2016

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