BCR-ABL1- and CBFB-MYH11-positive chronic myeloid leukemia presenting with primary blast crisis and marrow fibrosis

  • Keisuke Kidoguchi
  • Kensuke KojimaEmail author
  • Masako Yokoo
  • Shinya Kimura
Letter to the Editor

Dear Editor,

Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm characterized by the presence of the BCR-ABL1 fusion gene [1]. Bone marrow fibrosis leading to dry tap aspiration has been reported in patients with CML, frequently in association with blast crisis [2]. CBFB-MYH11 is a genomic abnormality in acute myeloid leukemia (AML) that predicts a favorable prognosis [1]. Here, we report a case of BCR-ABL1- and CBFB-MYH11-positive CML with primary blast crisis (CML-pBC) and marrow fibrosis.

A previously healthy 69-year-old woman was admitted to our hospital because of severe pneumonia and acute hypoxemic respiratory failure that required intubation and mechanical ventilation. Her hemoglobin level was 8.6 g/dL; white blood cell count was 234 × 10 9/L with 32% blasts, 2% promyelocytes, 6% myelocytes, 2% metamyelocytes, 29% neutrophils, 6% basophils, 13% eosinophils, 7% monocytes, and 3% lymphocytes; and platelet count was 648 × 10 9/L. The blasts were positive for...



This work was supported in part by grants from the Ministry of Education, Culture, Sports, Science, and Technology in Japan (17K09928 0001), the Yasuda Medical Foundation, the Foundation for Promotion of Cancer Research in Japan, the Project Mirai Cancer Research Grants, and the Japan Leukemia Research Fund.

Compliance with ethical standards

Written informed consent was obtained from the patients for publication.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of MedicineSaga UniversitySagaJapan
  2. 2.Department of HematologyKochi UniversityNankokuJapan

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