{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:01:06Z","timestamp":1760148066376,"version":"build-2065373602"},"reference-count":20,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,3,28]],"date-time":"2023-03-28T00:00:00Z","timestamp":1679961600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Relapsed acute lymphoblastic leukemia (ALL) represents a continuous challenge for the clinician. Despite recent advances in treatment, the risk of relapse remains significant. The clinical, biological, cytogenetic, and molecular characteristics may be different at the time of relapse. Current comprehensive genome sequencing studies suggest that most relapsed patients, especially those with late relapses, acquire new genetic abnormalities, usually within a minor clone that emerges after ALL diagnosis. We report the case of a 23-year-old young woman diagnosed with Philadelphia chromosome-negative B cell acute lymphoblastic leukemia. The patient underwent allogeneic stem cell transplantation (allo-HSCT) after complete remission. Despite having favorable prognostic factors at diagnosis, the disease relapsed early after allo-HSCT. The cytogenetic and molecular exams at relapse were positive for the Philadelphia chromosome, respectively for the Bcr-Abl transcript. What exactly led to the recurrence of this disease in a more aggressive cytogenetic and molecular form, although there were no predictive elements at diagnosis?<\/jats:p>","DOI":"10.3390\/medicina59040671","type":"journal-article","created":{"date-parts":[[2023,3,28]],"date-time":"2023-03-28T07:05:25Z","timestamp":1679987125000},"page":"671","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Philadelphia Chromosome, from Negative to Positive: A Case Report of Relapsed Acute Lymphoblastic Leukemia Following Allogeneic Stem Cell Transplantation"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7544-4974","authenticated-orcid":false,"given":"Elena-Cristina","family":"Marinescu","sequence":"first","affiliation":[{"name":"Department of Methodology and Scientific Research, \u201cCarol Davila\u201d University of Medicine and Pharmacy, Eroilor Sanitari Boulevard, No. 8, 050474 Bucharest, Romania"},{"name":"Department of Hematology, Emergency University Hospital of Bucharest, Splaiul Independentei, No. 169, 050098 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Horia","family":"Bumbea","sequence":"additional","affiliation":[{"name":"Department of Methodology and Scientific Research, \u201cCarol Davila\u201d University of Medicine and Pharmacy, Eroilor Sanitari Boulevard, No. 8, 050474 Bucharest, Romania"},{"name":"Department of Hematology, Emergency University Hospital of Bucharest, Splaiul Independentei, No. 169, 050098 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iuliana","family":"Iordan","sequence":"additional","affiliation":[{"name":"Department of Methodology and Scientific Research, \u201cCarol Davila\u201d University of Medicine and Pharmacy, Eroilor Sanitari Boulevard, No. 8, 050474 Bucharest, Romania"},{"name":"Department of Hematology, Emergency University Hospital of Bucharest, Splaiul Independentei, No. 169, 050098 Bucharest, Romania"},{"name":"Department of Medical Semiology and Nephrology, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ion","family":"Dumitru","sequence":"additional","affiliation":[{"name":"Department of Hematology, Emergency University Hospital of Bucharest, Splaiul Independentei, No. 169, 050098 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Soare","sequence":"additional","affiliation":[{"name":"Department of Methodology and Scientific Research, \u201cCarol Davila\u201d University of Medicine and Pharmacy, Eroilor Sanitari Boulevard, No. 8, 050474 Bucharest, Romania"},{"name":"Department of Hematology, Emergency University Hospital of Bucharest, Splaiul Independentei, No. 169, 050098 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina","family":"Ciufu","sequence":"additional","affiliation":[{"name":"Department of Methodology and Scientific Research, \u201cCarol Davila\u201d University of Medicine and Pharmacy, Eroilor Sanitari Boulevard, No. 8, 050474 Bucharest, Romania"},{"name":"Department of Hematology, Emergency University Hospital of Bucharest, Splaiul Independentei, No. 169, 050098 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mihaela","family":"Gaman","sequence":"additional","affiliation":[{"name":"Department of Hematology, Emergency University Hospital of Bucharest, Splaiul Independentei, No. 169, 050098 Bucharest, Romania"},{"name":"Department of Hematology, \u201cCarol Davila\u201d University of Medicine and Pharmacy, Eroilor Sanitari Boulevard, No. 8, 050474 Bucharest, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2524","DOI":"10.3324\/haematol.2020.247031","article-title":"Pediatric acute lymphoblastic leukemia","volume":"105","author":"Inaba","year":"2020","journal-title":"Haematologica"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3660","DOI":"10.1002\/cncr.28930","article-title":"Augmented Berlin-Frankfurt-M\u00fcnster therapy in adolescents and young adults (AYAs) with acute lymphoblastic leukemia (ALL)","volume":"120","author":"Rytting","year":"2014","journal-title":"Cancer"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1111\/j.1365-2141.2012.09095.x","article-title":"Outcomes in older adults with acute lymphoblastic leukaemia (ALL): Results from the international MRC UKALL XII\/ECOG2993 trial","volume":"157","author":"Sive","year":"2012","journal-title":"Br. 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