Concurrent JAK2 V617F Acute Myeloid Leukemia (AML) and Leukemic non-nodal Mantle Cell Lymphoma (LN-MCL): Case study

Abstract Introduction/Objective We report a unique case of concurrently occurring Acute Myeloid Leukemia (AML) and Leukemic non-nodal Mantle Cell Lymphoma (LN-MCL) in an 86-year-old male. To the best of our knowledge, this is the first report of AML occurring in the background of LN-MCL, with no kno...

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Bibliographic Details
Published in:American journal of clinical pathology 2022-11, Vol.158 (Supplement_1), p.S102-S102
Main Authors: Ohan, H, Inamdar, K, Shen, Y, liu, W, Gomez-Gelvez, J C, Ghosh, S
Format: Article
Language:English
Subjects:
Acute myeloid leukemia
Biopsy
Bone marrow
Case studies
CD13 antigen
CD34 antigen
CD5 antigen
CD56 antigen
Chemotherapy
Computed tomography
Flow cytometry
Heavy chains
Immunoglobulins
Janus kinase 2
Karyotypes
Leukemia
Lymphadenopathy
Lymphocytes
Lymphocytes B
Lymphoma
Malignancy
Mantle cell lymphoma
Next-generation sequencing
Pancytopenia
Peripheral blood
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Summary:Abstract Introduction/Objective We report a unique case of concurrently occurring Acute Myeloid Leukemia (AML) and Leukemic non-nodal Mantle Cell Lymphoma (LN-MCL) in an 86-year-old male. To the best of our knowledge, this is the first report of AML occurring in the background of LN-MCL, with no known history of any malignancy or chemotherapy. Methods/Case Report An 86-year old Caucasian male with unremarkable past medical history presented with pancytopenia, fatigue and generalized weakness. Abdominal CT scan was negative for lymphadenopathy or hepatosplenomegaly. Peripheral blood showed 2% blasts with atypical lymphocytes 89%. Bone marrow aspirate showed 30% myeloblasts expressing CD34, CD117, CD13, CD33, HLA-DR and CD56 (dim) by flow cytometry (FC). Lymphocytes accounted for 40% of bone marrow cellularity. FC identified a population of CD5+ kappa restricted clonal B cells 2%, consistent with a concurrent CD5+ B-lymphoproliferative disorder/lymphoma. The bone marrow biopsy was inadequate for further evaluation of the B- cell lymphoma. Chromosomal analysis revealed a normal male karyotype. FISH analysis was positive for t(11:14) CCND1::IGH rearrangement (in 3.5% of interphase cells) supporting involvement by MCL. Myeloid panel next generation sequencing (51 genes) was positive for JAK2 V617F (VAF, 38%) and ASXL1 P920Tfs*4 (VAF, 22%) variants Results (if a Case Study enter NA) NA Conclusion Concurrent presence of LN-MCL and AML as seen in our patient in the absence of prior history of malignancy or chemotherapy is rare. Presence of JAK2V617F mutation in de-novo AML is extremely rare (
ISSN:0002-9173
1943-7722
DOI:10.1093/ajcp/aqac126.215