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Open Access Case Report

Concurrent acute myeloid leukemia and T lymphoblastic lymphoma in a patient with rearranged PDGFRB genes

Hung Chang12*, Wen-Yu Chuang13, Chien-Feng Sun13 and Marc R Barnard4

Author Affiliations

1 School of Medicine, Chang Gung University, Taoyuan, Taiwan

2 Division of Hematology-Oncology Chang Gung Memorial Hospital, 5 Fu-Shing Street, Kweishan, Taoyuan 333, Taiwan

3 Department of Pathology, Chang Gung Memorial Hospital, Taipei, Taiwan

4 Core Flow Cytometry Laboratory, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA

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Diagnostic Pathology 2012, 7:19  doi:10.1186/1746-1596-7-19

Published: 22 February 2012

Abstract

Concurrent hematologic malignancies are relatively rare. We encountered a case of concurrent acute myeloid leukemia (AML) and T lymphoblastic lymphoma. The bone marrow chromosome analysis showed the karyotype 46, XY, t(5;12)(q33;p13), which indicated presence of PDGFRB gene translocations. Therefore, this disease belongs to the new WHO category of myeloid and lymphoid neoplasms with abnormalities in PDGFRA, PDGFRB and FGFR1 genes. Although such genetic mutations are prone to multi-lineage differentiation, the present case is in fact the first report of concurrent AML and T lymphoblastic lymphoma involving PDGFRB mutations. The patient was treated with cytarabine and daunomycin in combination with high dose dexamethasone. Allogeneic stem cell transplantation was performed after successful remission induction for both entities. The patient eventually died of chronic graft-versus-host-disease related infection. Based on such an experience, we suggest the decision of stem cell transplantation should be weighed carefully against the risks, especially when tyrosine kinase inhibitors are safe and potentially effective in dealing with such entities.

Keywords:
Acute myeloid leukemia; T lymphoblastic lymphoma; PDGFR genes; Chromosomal translocation; Transplantation