Bone window where cricoid blast transformation
becomes more evident.
The rate of blast transformation of CML is about 1.5% per year, which is significantly better compared to the preimatinib era .
It is proposed that blast transformation of CML is triggered by molecular or genetic mutations, such as trisomy 8, trisomy 19, isochromosome 17, t(3;21), mutations in p53, RB gene, RAS pathway, or p16/ARF pathway mutations .
In relation to the diagnosis of the underlying disease, the distribution of the patients was as follows: acute leukemia in 40% of the patients (13 patients had AML--including 3 cases of secondary AML not in CR nor PR, one patient had acute lymphoblastic leukemia), CML in 26% (9 patients, two were in resistant, blast transformation phase, two in acceleration phase), AA in 14% (five patients), MDS in 14% (five patients), MM in one patient as well as one case of Ewing sarcoma (ES).
Almost half of the CML patients were in blast transformation or acceleration phase of the disease, both phases known as prognostically unfavorable .
GS occurring in a setting of MDS/MPD is equivalent to blast transformation
Myeloid sarcoma (MS) is an extramedullary myeloid tumor (granulocytic sarcoma) that can occur in one of three clinical settings: (1) in patients who have a history of acute myeloid leukemia (AML), during active disease or a recurrence: (2) in patients with chronic myeloproliferative disorder or myelodysplastic syndromes, who are at increased risk of blast transformation
or acute leukemia; or (3) in patients with no history of hematologic disease, although it commonly predates the development of leukemia, often within 1 year.
1999), blast transformation of human lymphocytes (Meng and Meng 2000), and malignant transformation (tumors formed on injection of arsenic-transformed cells into nude mice) of the rat liver epithelial cell line TRL 1215 (Zhao et al.
Effects of arsenic on blast transformation and DNA synthesis of human blood lymphocytes.