{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T18:34:03Z","timestamp":1789842843864,"version":"4.0.1"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T00:00:00Z","timestamp":1740009600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T00:00:00Z","timestamp":1740009600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Discov Onc"],"DOI":"10.1007\/s12672-025-01932-6","type":"journal-article","created":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T18:22:41Z","timestamp":1740075761000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Myelodysplastic syndromes with del(20q) transformed into B-lineage acute lymphoblastic leukemia remaining with del(20q): a case report with literature review"],"prefix":"10.1007","volume":"16","author":[{"given":"Wenyi","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaomei","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peilei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongxia","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yali","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongliang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,20]]},"reference":[{"issue":"9","key":"1932_CR1","doi-asserted-by":"publisher","first-page":"872","DOI":"10.1001\/jama.2022.14578","volume":"328","author":"MA Sekeres","year":"2022","unstructured":"Sekeres MA, Taylor J. Diagnosis and treatment of myelodysplastic syndromes: a review. JAMA. 2022;328(9):872\u201380.","journal-title":"JAMA"},{"issue":"1","key":"1932_CR2","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1038\/s41572-022-00402-5","volume":"8","author":"H Li","year":"2022","unstructured":"Li H, Hu F, Gale RP, Sekeres MA, Liang Y. Myelodysplastic syndromes. Nat Rev Dis Primers. 2022;8(1):74.","journal-title":"Nat Rev Dis Primers"},{"issue":"1","key":"1932_CR3","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1182\/blood.2019000942","volume":"136","author":"AJ Menssen","year":"2020","unstructured":"Menssen AJ, Walter MJ. Genetics of progression from MDS to secondary leukemia. Blood. 2020;136(1):50\u201360.","journal-title":"Blood"},{"issue":"2","key":"1932_CR4","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1016\/j.leukres.2005.06.011","volume":"30","author":"P Disperati","year":"2006","unstructured":"Disperati P, Ichim CV, Tkachuk D, Chun K, Schuh AC, Wells RA. Progression of myelodysplasia to acute lymphoblastic leukaemia: implications for disease biology. Leuk Res. 2006;30(2):233\u20139.","journal-title":"Leuk Res"},{"issue":"2","key":"1932_CR5","doi-asserted-by":"publisher","first-page":"130","DOI":"10.3343\/alm.2013.33.2.130","volume":"33","author":"YR Koh","year":"2013","unstructured":"Koh YR, Cho EH, Park SS, Park MY, Lee SM, Kim IS, Lee EY. A rare case of transformation of childhood myelodysplastic syndrome to acute lymphoblastic leukemia. Ann Lab Med. 2013;33(2):130\u20135.","journal-title":"Ann Lab Med"},{"issue":"6","key":"1932_CR6","doi-asserted-by":"publisher","first-page":"5734","DOI":"10.3390\/ijms24065734","volume":"24","author":"C B\u0103nescu","year":"2023","unstructured":"B\u0103nescu C, Tripon F, Muntean C. The genetic landscape of myelodysplastic neoplasm progression to acute myeloid leukemia. Int J Mol Sci. 2023;24(6):5734.","journal-title":"Int J Mol Sci"},{"issue":"1","key":"1932_CR7","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1038\/s41591-018-0267-4","volume":"25","author":"J Chen","year":"2019","unstructured":"Chen J, Kao YR, Sun D, Todorova TI, Reynolds D, Narayanagari SR, Montagna C, Will B, Verma A, Steidl U. Myelodysplastic syndrome progression to acute myeloid leukemia at the stem cell level. Nat Med. 2019;25(1):103\u201310.","journal-title":"Nat Med"},{"issue":"12","key":"1932_CR8","doi-asserted-by":"publisher","first-page":"2993","DOI":"10.1080\/10428194.2019.1605509","volume":"60","author":"W Xie","year":"2019","unstructured":"Xie W, Chen Z, Wang SA, Hu S, Li S, Miranda RN, Medeiros LJ, Tang G. Lymphoblastic leukemia following myelodysplastic syndromes or myelodysplastic\/myeloproliferative neoplasms. Leuk Lymphoma. 2019;60(12):2993\u20133001.","journal-title":"Leuk Lymphoma"},{"issue":"12","key":"1932_CR9","first-page":"203","volume":"120","author":"K Nachtkamp","year":"2023","unstructured":"Nachtkamp K, Kobbe G, Gattermann N, Germing U. Myelodysplastic syndromes: new methods of diagnosis prognostication, and treatment. Dtsch Arztebl Int. 2023;120(12):203\u201310.","journal-title":"Dtsch Arztebl Int"},{"key":"1932_CR10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.blre.2018.09.001","volume":"34","author":"AM Zeidan","year":"2019","unstructured":"Zeidan AM, Shallis RM, Wang R, Davidoff A, Ma X. Epidemiology of myelodysplastic syndromes: why characterizing the beast is a prerequisite to taming it. Blood Rev. 2019;34:1\u201315.","journal-title":"Blood Rev"},{"issue":"1","key":"1932_CR11","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1007\/s00277-020-04114-2","volume":"100","author":"F Martins","year":"2021","unstructured":"Martins F, Kruszewski M, Scarpelli I, Schoumans J, Spertini O, L\u00fcbbert M, Blum S. Characterization of myelodysplastic syndromes progressing to acute lymphoblastic leukemia. Ann Hematol. 2021;100(1):63\u201378.","journal-title":"Ann Hematol"},{"issue":"6","key":"1932_CR12","doi-asserted-by":"publisher","first-page":"2079","DOI":"10.1182\/blood.V89.6.2079","volume":"89","author":"P Greenberg","year":"1997","unstructured":"Greenberg P, Cox C, LeBeau MM, Fenaux P, Morel P, Sanz G, Sanz M, Vallespi T, Hamblin T, Oscier D, Ohyashiki K, Toyama K, Aul C, Mufti G, Bennett J. International scoring system for evaluating prognosis in myelodysplastic syndromes. Blood. 1997;89(6):2079\u201388.","journal-title":"Blood"},{"issue":"4","key":"1932_CR13","doi-asserted-by":"publisher","first-page":"1508","DOI":"10.1590\/S1516-31801997000400009","volume":"115","author":"CS Lima","year":"1997","unstructured":"Lima CS, de Souza CA, Cardinalli IA, Lorand-Metze I. Lymphoblastic transformation of myelodysplastic syndrome. Sao Paulo Med J. 1997;115(4):1508\u201312.","journal-title":"Sao Paulo Med J"},{"issue":"5","key":"1932_CR14","doi-asserted-by":"publisher","first-page":"3570","DOI":"10.1007\/s12032-012-0297-6","volume":"29","author":"SS Rohr","year":"2012","unstructured":"Rohr SS, Pelloso LA, BorgoAdos S, de Rezende JG, Silva MR, Yamamoto M, de Lourdes LFCM. RARS with fibrosis and del(20q) transformed into ALL. Med Oncol. 2012;29(5):3570\u20133.","journal-title":"Med Oncol"},{"issue":"3","key":"1932_CR15","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1038\/s41408-018-0061-z","volume":"8","author":"J Schanz","year":"2018","unstructured":"Schanz J, Cevik N, Fonatsch C, Braulke F, Shirneshan K, Bacher U, Haase D. Detailed analysis of clonal evolution and cytogenetic evolution patterns in patients with myelodysplastic syndromes (MDS) and related myeloid disorders. Blood Cancer J. 2018;8(3):28.","journal-title":"Blood Cancer J"},{"issue":"12","key":"1932_CR16","doi-asserted-by":"publisher","first-page":"2847","DOI":"10.1080\/10428194.2019.1666382","volume":"60","author":"S Gurbuxani","year":"2019","unstructured":"Gurbuxani S. Lymphoblastic leukemia following MDS or MDS\/MPN: clinical evidence for stem cell origins of these disorders. Leuk Lymphoma. 2019;60(12):2847\u20138.","journal-title":"Leuk Lymphoma"},{"issue":"10","key":"1932_CR17","doi-asserted-by":"publisher","first-page":"2809","DOI":"10.1182\/blood.V83.10.2809.2809","volume":"83","author":"NJ White","year":"1994","unstructured":"White NJ, Nacheva E, Asimakopoulos FA, Bloxham D, Paul B, Green AR. Deletion of chromosome 20q in myelodysplasia can occur in a multipotent precursor of both myeloid cells and B cells. Blood. 1994;83(10):2809\u201316.","journal-title":"Blood"},{"issue":"2","key":"1932_CR18","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1038\/s41568-020-00315-z","volume":"21","author":"JM Klco","year":"2021","unstructured":"Klco JM, Mullighan CG. Advances in germline predisposition to acute leukaemias and myeloid neoplasms. Nat Rev Cancer. 2021;21(2):122\u201337.","journal-title":"Nat Rev Cancer"},{"issue":"22","key":"1932_CR19","doi-asserted-by":"publisher","first-page":"3616","DOI":"10.1182\/blood-2013-08-518886","volume":"122","author":"E Papaemmanuil","year":"2013","unstructured":"Papaemmanuil E, Gerstung M, Malcovati L, Tauro S, Gundem G, Van Loo P, Yoon CJ, Ellis P, Wedge DC, Pellagatti A, Shlien A, Groves MJ, Forbes SA, Raine K, Hinton J, Mudie LJ, McLaren S, Hardy C, Latimer C, Della Porta MG, O\u2019Meara S, Ambaglio I, Galli A, Butler AP, Walldin G, Teague JW, Quek L, Sternberg A, Gambacorti-Passerini C, Cross NC, Green AR, Boultwood J, Vyas P, Hellstrom-Lindberg E, Bowen D, Cazzola M, Stratton MR, Campbell PJ. Clinical and biological implications of driver mutations in myelodysplastic syndromes. Blood. 2013;122(22):3616\u201327 (quiz 3699).","journal-title":"Blood"},{"issue":"18","key":"1932_CR20","doi-asserted-by":"publisher","first-page":"2793","DOI":"10.1182\/blood-2014-04-522136","volume":"124","author":"R Bejar","year":"2014","unstructured":"Bejar R, Steensma DP. Recent developments in myelodysplastic syndromes. Blood. 2014;124(18):2793\u2013803.","journal-title":"Blood"},{"issue":"1","key":"1932_CR21","doi-asserted-by":"publisher","first-page":"e14011","DOI":"10.1097\/MD.0000000000014011","volume":"98","author":"S Burgos","year":"2019","unstructured":"Burgos S, Montalban-Bravo G, Fuente L, Jabbour EJ, Kanagal-Shamanna R, Soltysiak KA, Garcia-Manero G, Mela-Osorio MJ. Novel EZH2 mutation in a patient with secondary B-cell acute lymphocytic leukemia after deletion 5q myelodysplastic syndrome treated with lenalidomide: a case report. Medicine. 2019;98(1):e14011.","journal-title":"Medicine"},{"issue":"6","key":"1932_CR22","first-page":"9745","volume":"15","author":"ZP Guo","year":"2018","unstructured":"Guo ZP, Tan YH, Li JL, Xu ZF, Chen XH, Xu LR. Acute pro-B-Cell lymphoblastic leukemia transformed from myelodysplastic syndrome with an ASXL1 missense mutation: a case report with literature review. Oncol Lett. 2018;15(6):9745\u201350.","journal-title":"Oncol Lett"},{"issue":"7","key":"1932_CR23","doi-asserted-by":"publisher","first-page":"8119","DOI":"10.18632\/oncotarget.6992","volume":"7","author":"F Xu","year":"2016","unstructured":"Xu F, Liu L, Chang CK, He Q, Wu LY, Zhang Z, Shi WH, Guo J, Zhu Y, Zhao YS, Gu SC, Fei CM, Li X. Genomic loss of EZH2 leads to epigenetic modifications and overexpression of the HOX gene clusters in myelodysplastic syndrome. Oncotarget. 2016;7(7):8119\u201330.","journal-title":"Oncotarget"},{"issue":"2","key":"1932_CR24","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1111\/j.1365-2141.2009.07586.x","volume":"145","author":"NA Trikalinos","year":"2009","unstructured":"Trikalinos NA, Soupir CP, Dey BR. Lineage switch of acute lymphocyctic leukaemia with t(4;11)(q21;q23) into acute myeloid leukaemia in an adult patient after allogeneic stem cell transplantation. Br J Haematol. 2009;145(2):262\u20134.","journal-title":"Br J Haematol"},{"issue":"2","key":"1932_CR25","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1016\/j.cancergencyto.2006.02.013","volume":"168","author":"C Stasik","year":"2006","unstructured":"Stasik C, Ganguly S, Cunningham MT, Hagemeister S, Persons DL. Infant acute lymphoblastic leukemia with t(11;16)(q23;p13.3) and lineage switch into acute monoblastic leukemia. Cancer Genet Cytogenet. 2006;168(2):146\u20139.","journal-title":"Cancer Genet Cytogenet"},{"key":"1932_CR26","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1016\/j.critrevonc.2017.12.013","volume":"122","author":"C Wang","year":"2018","unstructured":"Wang C, Yang Y, Gao S, Chen J, Yu J, Zhang H, Li M, Zhan X, Li W. Immune dysregulation in myelodysplastic syndrome: Clinical features, pathogenesis and therapeutic strategies. Crit Rev Oncol Hematol. 2018;122:123\u201332.","journal-title":"Crit Rev Oncol Hematol"},{"issue":"12","key":"1932_CR27","doi-asserted-by":"publisher","first-page":"2015","DOI":"10.1007\/s00262-019-02420-x","volume":"68","author":"P Montes","year":"2019","unstructured":"Montes P, Bernal M, Campo LN, Gonz\u00e1lez-Ram\u00edrez AR, Jim\u00e9nez P, Garrido P, Jurado M, Garrido F, Ruiz-Cabello F, Hern\u00e1ndez F. Tumor genetic alterations and features of the immune microenvironment drive myelodysplastic syndrome escape and progression. Cancer Immunol Immunother. 2019;68(12):2015\u201327.","journal-title":"Cancer Immunol Immunother"},{"issue":"1","key":"1932_CR28","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1186\/s13287-020-01647-1","volume":"11","author":"K Syed","year":"2020","unstructured":"Syed K, Naguib S, Liu ZJ, Cimmino L, Yang FC. Novel combinations to improve hematopoiesis in myelodysplastic syndrome. Stem Cell Res Ther. 2020;11(1):132.","journal-title":"Stem Cell Res Ther"},{"issue":"3","key":"1932_CR29","doi-asserted-by":"publisher","first-page":"580","DOI":"10.3390\/cells11030580","volume":"11","author":"OF Lynch","year":"2022","unstructured":"Lynch OF, Calvi LM. Immune dysfunction, cytokine disruption, and stromal changes in myelodysplastic syndrome: a review. Cells. 2022;11(3):580.","journal-title":"Cells"},{"issue":"3","key":"1932_CR30","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1016\/S1470-2045(13)70609-0","volume":"15","author":"A Palumbo","year":"2014","unstructured":"Palumbo A, Bringhen S, Kumar SK, Lupparelli G, Usmani S, Waage A, Larocca A, van der Holt B, Musto P, Offidani M, Petrucci MT, Evangelista A, Zweegman S, Nooka AK, Spencer A, Dimopoulos MA, Hajek R, Cavo M, Richardson P, Lonial S, Ciccone G, Boccadoro M, Anderson K, Barlogie B, Sonneveld P, McCarthy PL. Second primary malignancies with lenalidomide therapy for newly diagnosed myeloma: a meta-analysis of individual patient data. Lancet Oncol. 2014;15(3):333\u201342.","journal-title":"Lancet Oncol"},{"issue":"12","key":"1932_CR31","doi-asserted-by":"publisher","first-page":"e906","DOI":"10.1016\/S2352-3026(22)00289-7","volume":"9","author":"K Saleem","year":"2022","unstructured":"Saleem K, Franz J, Klem ML, Yabes JG, Boyiadzis M, Jones JR, Shaikh N, Lontos K. Second primary malignancies in patients with haematological cancers treated with lenalidomide: a systematic review and meta-analysis. Lancet Haematol. 2022;9(12):e906\u201318.","journal-title":"Lancet Haematol"},{"issue":"7","key":"1932_CR32","doi-asserted-by":"publisher","first-page":"1694","DOI":"10.1002\/cam4.721","volume":"5","author":"DE Rollison","year":"2016","unstructured":"Rollison DE, Shain KH, Lee JH, Hampras SS, Fulp W, Fisher K, Al Ali NH, Padron E, Lancet J, Xu Q, Olesnyckyj M, Kenvin L, Knight R, Dalton W, List A, Komrokji RS. Subsequent primary malignancies and acute myelogenous leukemia transformation among myelodysplastic syndrome patients treated with or without lenalidomide. Cancer Med. 2016;5(7):1694\u2013701.","journal-title":"Cancer Med"},{"issue":"4","key":"1932_CR33","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1007\/s00277-009-0846-z","volume":"89","author":"G G\u00f6hring","year":"2010","unstructured":"G\u00f6hring G, Giagounidis A, B\u00fcsche G, Kreipe HH, Zimmermann M, Hellstr\u00f6m-Lindberg E, Aul C, Schlegelberger B. Patients with del(5q) MDS who fail to achieve sustained erythroid or cytogenetic remission after treatment with lenalidomide have an increased risk for clonal evolution and AML progression. Ann Hematol. 2010;89(4):365\u201374.","journal-title":"Ann Hematol"},{"issue":"3","key":"1932_CR34","first-page":"322","volume":"4","author":"NM Agostino","year":"2011","unstructured":"Agostino NM, Ahmed B, Popescu D, Gheith S. Transformation of the 5q- syndrome to acute lymphoblastic leukemia: a report of two cases and review of the literature. Int J Clin Exp Pathol. 2011;4(3):322\u20136.","journal-title":"Int J Clin Exp Pathol"},{"issue":"12","key":"1932_CR35","doi-asserted-by":"publisher","first-page":"1762","DOI":"10.3324\/haematol.2009.011528","volume":"94","author":"M J\u00e4dersten","year":"2009","unstructured":"J\u00e4dersten M, Saft L, Pellagatti A, G\u00f6hring G, Wainscoat JS, Boultwood J, Porwit A, Schlegelberger B, Hellstr\u00f6m-Lindberg E. Clonal heterogeneity in the 5q- syndrome: p53 expressing progenitors prevail during lenalidomide treatment and expand at disease progression. Haematologica. 2009;94(12):1762\u20136.","journal-title":"Haematologica"},{"issue":"12","key":"1932_CR36","doi-asserted-by":"publisher","first-page":"2454","DOI":"10.1182\/blood-2012-03-420489","volume":"120","author":"PL Greenberg","year":"2012","unstructured":"Greenberg PL, Tuechler H, Schanz J, Sanz G, Garcia-Manero G, Sol\u00e9 F, Bennett JM, Bowen D, Fenaux P, Dreyfus F, Kantarjian H, Kuendgen A, Levis A, Malcovati L, Cazzola M, Cermak J, Fonatsch C, Le Beau MM, Slovak ML, Krieger O, Luebbert M, Maciejewski J, Magalhaes SM, Miyazaki Y, Pfeilst\u00f6cker M, Sekeres M, Sperr WR, Stauder R, Tauro S, Valent P, Vallespi T, van de Loosdrecht AA, Germing U, Haase D. Revised international prognostic scoring system for myelodysplastic syndromes. Blood. 2012;120(12):2454\u201365.","journal-title":"Blood"}],"container-title":["Discover Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12672-025-01932-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s12672-025-01932-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s12672-025-01932-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T18:22:43Z","timestamp":1740075763000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s12672-025-01932-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,20]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["1932"],"URL":"https:\/\/doi.org\/10.1007\/s12672-025-01932-6","relation":{},"ISSN":["2730-6011"],"issn-type":[{"value":"2730-6011","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,20]]},"assertion":[{"value":"5 November 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 February 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 February 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All procedures involving human participants were performed in accordance with the Declaration of Helsinki (as revised in 2013). Written informed consent was acquired from this patient. This study was approved by the Ethics Review Committee of LANGFANG TCM hospital with an approval number of LW2024-001.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The participant has consented to the submission of the case report to the journal. Written informed consent was obtained from the patient for publication of the details of his medical case and any accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"217"}}