Abnormal chromatin clumping in leucocytes of Ph positive chronic myeloid leukemia cases - extending the morphological...

Area of Science:

• Hematology
• Oncology
• Morphology

Background:

• The World Health Organization classifies abnormal chromatin clumping as a variant of atypical chronic myeloid leukemia (aCML) or Ph-negative CML.
• Most reported cases of abnormal chromatin clumping are negative for the Philadelphia chromosome (Ph) or BCR-ABL gene.
• Ph positivity has been documented in only one previous case.

Observation:

• This study reports two new cases of Philadelphia chromosome-positive chronic myeloid leukemia (Ph+ CML) presenting with abnormal chromatin clumping in neutrophils.
• This finding is significant as it represents only the second description of such cases in the medical literature.

Findings:

• The two cases extend the known morphological spectrum of granulocytic changes observed in Ph-positive CML.
• Abnormal chromatin clumping, previously associated mainly with Ph-negative CML, is now shown to occur in Ph-positive CML.

Implications:

• These findings broaden the understanding of CML morphology.
• The presence of abnormal chromatin clumping in Ph-positive CML may necessitate a re-evaluation of diagnostic criteria and classification.
• Further research is warranted to explore the underlying mechanisms and clinical significance of this morphological variant in Ph-positive CML.