{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T17:36:41Z","timestamp":1777225001350,"version":"3.51.4"},"reference-count":39,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["eJHaem"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic myeloid leukemia (CML) presenting in blast crisis (BC) is uncommon in the era of tyrosine kinase inhibitor (TKI) treatment, and T\u2010lymphoblastic BC is exceptionally rare. We report a case of T\u2010lymphoid BC presenting with extreme hyperleukocytosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>\n                      A 37\u2010year\u2010old woman with previously diagnosed chronic phase CML who had declined therapy presented with dyspnea and constitutional symptoms. She was found to have diffuse lymphadenopathy and a markedly elevated white cell count (WCC) of 729\u00a0\u00d7\u00a010\n                      <jats:sup>9<\/jats:sup>\n                      \/L with 24% blasts. Bone marrow biopsy showed T\u2010lymphoblastic leukemia,\n                      <jats:italic>BCR::ABL1<\/jats:italic>\n                      fusion (p210), and a\n                      <jats:italic>RUNX1<\/jats:italic>\n                      gene mutation as well as an IKZF1 gene mutation. Staging revealed extensive nodal, splenic, renal, and ocular involvement. She underwent cytoreduction with hydroxyurea, prednisone, and dasatinib, followed by HyperCVAD induction. She achieved complete remission and proceeded to a sibling\u2010donor allogeneic stem cell transplant. A bone marrow biopsy 100\u00a0days after transplant showed complete remission without MRD assessed by PCR and flow cytometry. At 6\u00a0months post\u2010transplant, she remains disease\u2010free.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>T\u2010lymphoid BC in CML is exceedingly rare, with limited knowledge of disease characteristics, molecular features, prognosis, and treatment outcomes. This case highlights the importance of early recognition, comprehensive molecular workup, and aggressive therapy. Despite historically poor outcomes, aggressive induction with BCR\u2010ABL1 kinase inhibition followed by transplant may offer durable disease control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>The authors have confirmed clinical trial registration is not needed for this submission.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jha2.70213","type":"journal-article","created":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T06:35:23Z","timestamp":1773470123000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Chronic Myeloid Leukemia Presenting With T\u2010Lymphoid Blast Crisis in a Young Female With Marked Hyperleukocytosis: A Case Report"],"prefix":"10.1002","volume":"7","author":[{"given":"E.","family":"Somasundaram","sequence":"first","affiliation":[{"name":"Department of Medicine Massachusetts General Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. 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