{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T15:16:25Z","timestamp":1782227785548,"version":"3.54.5"},"reference-count":18,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,10,8]],"date-time":"2020-10-08T00:00:00Z","timestamp":1602115200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cytometry Part B Clinical"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Inconclusive knowledge persists regarding the course of chronic myeloid leukemia\u2010chronic phase (CML\u2010CP) patients with detectable abnormal blasts by flow\u2010cytometry at diagnosis. The 2016 WHO classification is not specific regarding sub\u2010classification of CML with &lt;10% abnormal B\u2010lymphoid blasts (ABLB), and suggests these patients often show rapid progression. We report the clinical course of pediatric CML\u2010CP patients who had detectable abnormal blasts by flow\u2010cytometry at baseline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective audit of all pediatric CML patients between January 2013 and December 2017 were included. Their clinical presentation, demographic profile, and treatment outcomes were extracted from electronic medical records. Some of these patients got flow\u2010cytometry done by default, though it was not a routine part of diagnostic CML marrow studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Amongst 65 pediatric CML patients, flow\u2010cytometry at initial diagnosis was available in 15 (CP\u201012; AP\u20103). Of the 12 CML\u2010CP patients, 10 (83%) had abnormal flow\u2010cytometric findings\u20145 (50%) with mixed lineage blasts (4\u2010B\/Myeloid, 1\u2010B\/T\/Myeloid), and myeloid lineage blasts in the remaining 5 (50%). At a median follow\u2010up of 26\u2009months (range: 9\u201334\u2009months), 3\/5 patients with ABLB at diagnosis progressed to frank blast crisis (2 B\u2010cell; 1 Mixed lineage). None among the five patients with diagnostic myeloid\u2010alone aberrant blasts progressed to blast crisis. Imatinib resistant mutation was also found in 3\/5 (60%) CML\u2010CP patients with these ABLB at baseline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although a retrospective study with limited sample size, presence of ABLB detected on flow\u2010cytometry in CML\u2010CP patients, had a noticeable early conversion to CML\u2010BC in our cohort. Incorporation of flow\u2010cytometry in diagnostic work\u2010up can provide useful insight regarding the behavior of pediatric CML\u2010CP patients and guide therapy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cyto.b.21958","type":"journal-article","created":{"date-parts":[[2020,10,8]],"date-time":"2020-10-08T10:54:42Z","timestamp":1602154482000},"page":"345-351","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Sudden blast phase in pediatric chronic myeloid leukemia\u2010chronic phase with abnormal lymphoid blasts detected by flow cytometry at diagnosis: Can it be considered a warning sign?"],"prefix":"10.1002","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3796-8782","authenticated-orcid":false,"given":"Kalasekhar","family":"Vijayasekharan","sequence":"first","affiliation":[{"name":"Department of Medical Oncology Tata Memorial Center  Mumbai Maharashtra India"},{"name":"Homi Bhabha National 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