PMC9240361_01
Wright-Giemsa-stained bone marrow aspirate smears. Small hypolobate megakaryocyte (arrow), hypogranular neutrophils (arrowhead), and numerous immature mononuclear cells morphologically consistent with blasts (open arrow) (Panel A, 400x, B, 200x, and C, 400x).
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Her most recent bone marrow aspirate and biopsy (BM bx), six weeks prior to admission, had revealed a MDS-EB2, with 15% blasts (Fig. 1) positive for HLA-DR, CD45 (dim), CD117, CD34, CD11b, CD56 (partial), cMPO, and a complex karyotype with autosomal monosomies and structural abnormalities (47-53,XX,add(2)(q33),-3,del(5)(q22q35),der(6)t(6;13)(p23;q12),add(7)(q22),+8,-13,der(14)t(3;14)(q21;q22),-18,+21,+21,+22,+0-2r,+2-3mar[cp16]/46,XX).
A. Fluorescence in-situ hybridization shows BCR/ABL1 fusion signal (arrow). B. Chromosomes 9 (ABL1) and 22 (BCR) with break-points depicted (9q34.1 and 22q11.2, respectively).
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The reverse transcriptase-polymerase chain reaction (RT-PCR) analysis showed a minor (p190, e1a2) BCR-ABL1 fusion mRNA transcript (Fig. 2).