Zhu YJ, Ma XY, Hao YL, Guan Y. Myelodysplastic syndrome transformed into B-lineage acute lymphoblastic leukemia: A case report. World J Clin Cases 2021; 9(19): 5191-5196 [PMID: 34307566 DOI: 10.12998/wjcc.v9.i19.5191]
Corresponding Author of This Article
Yun Guan, PhD, Doctor, Department of Hematology, Jining First People’s Hospital, No. 6 Jiankang Road, Jining 272000, Shandong Province, China. gyuanun1989@163.com
Research Domain of This Article
Hematology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jul 6, 2021; 9(19): 5191-5196 Published online Jul 6, 2021. doi: 10.12998/wjcc.v9.i19.5191
Myelodysplastic syndrome transformed into B-lineage acute lymphoblastic leukemia: A case report
Ye-Jing Zhu, Xiang-Yu Ma, Yun-Liang Hao, Yun Guan
Ye-Jing Zhu, Department of Clinical Medicine, Clinical College of Jining Medical University, Jining 272000, Shandong Province, China
Xiang-Yu Ma, Department of Science and Education, People's Hospital of Rizhao, Rizhao 276800, Shandong Province, China
Yun-Liang Hao, Yun Guan, Department of Hematology, Jining First People’s Hospital, Jining 272000, Shandong Province, China
Author contributions: Zhu YJ, Guan Y, and Ma XY contributed to data curation; Hao YL contributed to project administration; Zhu YJ and Ma XY contributed to resources; Hao YL contributed to fund acquisition; Zhu YJ and Guan Y wrote the first draft and reviewed and edited the manuscript.
Supported byShandong Medicine and Health Science Technology Development Plan, No. 2017WSA08039; Jining Key Research and Development Program, No. 2018SMNS008; Doctoral Research Startup Foundation of Jining First People’s Hospital, No. 2019003; and TCM Technology Development Plan, No. 20190744.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yun Guan, PhD, Doctor, Department of Hematology, Jining First People’s Hospital, No. 6 Jiankang Road, Jining 272000, Shandong Province, China. gyuanun1989@163.com
Received: December 13, 2020 Peer-review started: December 13, 2020 First decision: March 27, 2021 Revised: April 6, 2021 Accepted: May 8, 2021 Article in press: May 8, 2021 Published online: July 6, 2021 Processing time: 188 Days and 21.3 Hours
Abstract
BACKGROUND
Myelodysplastic syndromes (MDSs) are a group of hematological diseases caused by expansion of an abnormal clone of hematopoietic stem cells. Primary MDS is a potentially premalignant clonal disorder that may progress to overt acute leukemia in 25%-50% of cases. However, most of these cases evolve into acute myeloid leukemia and rarely progress to acute lymphoblastic leukemia (ALL). Thus, transformation of MDS into B-cell ALL is rare.
CASE SUMMARY
A 58-year-old man was admitted to the hospital for reduced blood cell counts. Based on all the test results and the World Health Organization diagnosis and classification, the patient was finally diagnosed with ring-shaped sideroblastic MDS with refractory hemocytopenia due to multilineage dysplasia. We used red blood cell transfusions and other symptomatic support treatments. After 4 years, the patient felt dizziness, fatigue, and night sweats. We improved bone marrow and peripheral blood and other related auxiliary examinations. He was eventually diagnosed with B-lineage acute lymphocytic leukemia (MDS transformation).
CONCLUSION
The number of peripheral blood cells, type of MDS, proportion of primitive cells in bone marrow, and number and quality of karyotypes are all closely related to the conversion of MDS to ALL.
Core Tip: We present a case of ring-shaped sideroblastic myelodysplastic syndrome, with refractory hemocytopenia due to multi-lineage dysplasia, that was transformed into B-cell acute lymphoblastic leukemia. Even though the lymphoid progression in myelodysplastic syndrome has been reported previously, most displayed myeloid-lymphoid hybrid, B cell acute lymphoblastic leukemia is rarely reported, and the specific mechanism is still unclear. We report a rare lymphoid transformation in order to provide information for the study of specific mechanism, and help doctors to provide appropriate treatment to patients.
