Abstract
Chronic myelogenous leukemia (CML) is a clonal disease of a pluripotent stem cell compartment, and lymphoblastic transformation in CML has been noted. Conversely, malignant diseases that were primarily lymphoid at onset have been documented to evolve into myeloproliferative disorders with and without the presence of a Philadelphia chromosome. We have observed a 3 3/2; year old girl who presented with a diffuse lymphoblastic non-Hodgkin's lymphoma involving liver, spleen, bone marrow, and an inguinal lymph node. Therapy with vincristine, prednisone, and cyclophosphamide resulted in complete remission for over 18 months. Subsequently she developed features of a myeloproliferative disorder characterized by basophilic meningitis, splenomegaly, and hypereosinophilia (WBC-142,000 with 63% eosinophils) plus hyperbasophilia, markedly elevated serum B12, and absent neutrophil alkaline phosphatase. Peripheral blood eosinophils and basophils were noted to form spontaneous rosettes with sheep RBC (E rosettes), a feature not present in normal eosinophils. The initial presentation of this patient as a lymphoma along with the presence of T-lymphocyte surface markers on eosinophils as the myeloproliferative phase of this disease evolved is further evidence for a lymphoid differentiation in certain myeloproliferative diseases such as CML.
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Rosen, R., Hutter, J. & Corrigan, J. E-ROSETTE POSITIVE EOSINOPHILS AND BASOPHILS IN A LYMPHOMYELOPROLIFERATIVE DISORDER. Pediatr Res 11, 479 (1977). https://doi.org/10.1203/00006450-197704000-00657
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DOI: https://doi.org/10.1203/00006450-197704000-00657