{
  "abstract": "Chronic myeloid leukemia (CML) is a BCR::ABL1-positive myeloid neoplasm characterized by the Philadelphia chromosome resulting from t(9;22)(q34;q11.2). Although tyrosine kinase inhibitors (TKIs) have substantially improved outcomes in chronic-phase CML, progression to blast phase remains an important feature of advanced disease. The majority of CML blast-phase cases demonstrate myeloid or precursor B-cell differentiation, whereas T-lineage transformation is uncommon. Early T-cell precursor acute lymphoblastic leukemia (ETP-ALL) represents an immature T-lineage neoplasm characterized by expression of cytoplasmic CD3 and CD7, weak or absent expression of conventional mature T-cell antigens, and frequent expression of myeloid or stem-cell-associated markers. A 35-year-old man with a known diagnosis of CML in chronic phase, receiving dasatinib and reported to be a frequent treatment defaulter, presented with blast transformation. Peripheral blood examination demonstrated marked leukocytosis, anemia, and thrombocytopenia, with 64% circulating blasts. The blasts were large, with scant cytoplasm and pleomorphic nuclei. Flow cytometric immunophenotyping identified an abnormal blast population comprising approximately 82% of viable events. The blasts expressed CD34, HLA-DR, CD123, cytoplasmic CD3, CD5 (dim), CD7, CD13, and CD33, with variable expression of CD117 and CD56. They were negative for surface CD3, CD1a, CD4, CD8, B-lineage markers, TCR-γδ, and myeloperoxidase. The overall immunophenotype was consistent with ETP-ALL. Cytogenetic analysis demonstrated 47,XY,del(7)(q21),+8,t(9;22)(q34;q11.2), indicating the presence of the Philadelphia chromosome together with trisomy 8 and del(7q). Molecular analysis detected an ABL1 p.Phe317Leu (F317L) kinase-domain mutation. This case represents a rare instance of CML blast phase with an ETP lymphoblastic phenotype and demonstrates the coexistence of an ABL1 F317L kinase-domain mutation and additional cytogenetic abnormalities, including trisomy 8 and del(7q). The case emphasizes the importance of integrating the clinical history with morphologic, flow cytometric, cytogenetic, and molecular findings when an immature T-cell leukemia is identified in a patient with established CML.",
  "abstract_shown": true,
  "affiliations": [
    "Pathology, American Institute of Pathology and Laboratory Sciences Pvt. Ltd. (AMPATH), Hyderabad, IND",
    "Cytogenetics, American Institute of Pathology and Laboratory Sciences Pvt. Ltd. (AMPATH), Hyderabad, IND",
    "Hematology, Citizens Specialty Hospitals, Hyderabad, IND",
    "Genetics, American Institute of Pathology and Laboratory Sciences Pvt. Ltd. (AMPATH), Hyderabad, IND"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Sushma Cherukuru"
    },
    {
      "affs": [
        1
      ],
      "name": "Surya Prakashrao"
    },
    {
      "affs": [
        2
      ],
      "name": "Sachin J"
    },
    {
      "affs": [
        3
      ],
      "name": "Mukkanteswararao Kasaragadda"
    },
    {
      "affs": [
        3
      ],
      "name": "Sambasivarao Patibandla"
    },
    {
      "affs": [
        3
      ],
      "name": "Kiran K"
    },
    {
      "affs": [
        3
      ],
      "name": "Shalini Singh"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5qemby14z89jf.bib",
  "cited_by": 0,
  "doi": "10.7759/cureus.117154",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13718997/?tool=EBI",
  "id": "5qemby14z89jf",
  "issns": [
    "2168-8184"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13718997",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Genetics"
    ],
    [
      "heading",
      "Hematology"
    ],
    [
      "heading",
      "Oncology"
    ],
    [
      "openalex",
      "2720|Chronic Myeloid Leukemia Treatments"
    ]
  ],
  "openalex": "W7214770490",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13718997/pdf/?tool=EBI",
  "pmcid": "PMC13718997",
  "pmid": "42960313",
  "published": "2026-09-29",
  "publisher": "Cureus Inc.",
  "ris": "https://research.draconitic.com/paper/5qemby14z89jf.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T00:20:37Z",
      "native_id": "PMC:PMC13718997",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13718997"
    },
    {
      "first_seen": "2026-11-01T00:20:52Z",
      "native_id": "MED:42960313",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42960313"
    },
    {
      "first_seen": "2026-11-02T12:22:55Z",
      "native_id": "PMC13718997",
      "source": "pmc",
      "url": "https://doi.org/10.7759/cureus.117154"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "heading:Genetics",
      "subfield": "genetics-genomics"
    },
    {
      "field": "medicine",
      "origin": "heading:Oncology",
      "subfield": "oncology"
    }
  ],
  "title": "Chronic Myeloid Leukemia Progressing to Early T-Cell Precursor Lymphoblastic Blast Phase Following Treatment Default: An Integrated Morphologic, Immunophenotypic, Cytogenetic, and Molecular Case Report",
  "title_text": "Chronic Myeloid Leukemia Progressing to Early T-Cell Precursor Lymphoblastic Blast Phase Following Treatment Default: An Integrated Morphologic, Immunophenotypic, Cytogenetic, and Molecular Case Report",
  "type": "peer-reviewed",
  "updated_at": "2026-11-02T12:22:55Z",
  "url": "https://research.draconitic.com/paper/5qemby14z89jf",
  "venue": "Cureus",
  "versions": []
}