Granulocytic dysplasia: an indicator of clonal evolution in patients with chronic myeloid leukemia

Sweta Rajpal; Ram V. Nampoothiri; Sreejesh Sreedharanunni; Mayur Parihar; Pankaj Malhotra; Neelam Varma

doi:10.5045/br.2018.53.2.180

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Blood Res 2018; 53(2):

Published online June 25, 2018

https://doi.org/10.5045/br.2018.53.2.180

Granulocytic dysplasia: an indicator of clonal evolution in patients with chronic myeloid leukemia

Sweta Rajpal¹, Ram V. Nampoothiri², Sreejesh Sreedharanunni^1*, Mayur Parihar³, Pankaj Malhotra², and Neelam Varma¹

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¹Department of Hematology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

²Division of Clinical Hematology, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

³Department of Cytogenetics and Laboratory Hematology, Tata Medical Center, Kolkata, India.

Correspondence to : Sreejesh Sreedharanunni. Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India. dr.s.sreejesh@gmail.com

Received: December 19, 2017; Revised: January 16, 2018; Accepted: May 10, 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article

Letter to the Editor

Blood Res 2018; 53(2): 180-181

Published online June 25, 2018 https://doi.org/10.5045/br.2018.53.2.180

Granulocytic dysplasia: an indicator of clonal evolution in patients with chronic myeloid leukemia

Sweta Rajpal¹, Ram V. Nampoothiri², Sreejesh Sreedharanunni^1*, Mayur Parihar³, Pankaj Malhotra², and Neelam Varma¹

¹Department of Hematology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

²Division of Clinical Hematology, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

³Department of Cytogenetics and Laboratory Hematology, Tata Medical Center, Kolkata, India.

Correspondence to:Sreejesh Sreedharanunni. Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India. dr.s.sreejesh@gmail.com

Received: December 19, 2017; Revised: January 16, 2018; Accepted: May 10, 2018

Fig 1.

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Figure 1.(A-C) Peripheral blood film shows significant dysgranulopoiesis in the form of hypolobation of the nucleus, hypogranulation, and abnormal coarse chromatin clumping. Platelet anisocytosis with large and giant platelets were also found. (D, E) Hypercellular bone marrow shows dysgranulopoiesis and many dwarf megakaryocytes (×40, May–Grunwald Giemsa stain). (F) Fluorescent in situ hybridization (FISH) using BCR/ABL1/ASS1 Tri-Color Dual Fusion Probe shows 1 orange aqua (normal ASS1-ABl1 gene), 1 green (normal BCR gene), 1 orange aqua green (from derivative chromosome 9 with ASS1-ABL1-BCR fusion gene), and 2 orange green fusion (from derivative 22 with BCR-ABL1 fusion genes) signals, which are consistent with the presence of an extra Philadelphia chromosome. (G) FISH using TP53/CEP17 probe shows 1 orange (from TP53 gene) and 2 green signals (from centromere of chromosome 17), which is consistent with loss of 1 copy of TP53 gene in concordance with isochromosome 17q.

Blood Research 2018; 53: 180-181https://doi.org/10.5045/br.2018.53.2.180