Therapy-Related B-cell Acute Lymphoblastic Leukemia: A Case Series and Literature Review

Therapy-related B-cell acute lymphoblastic leukemia (B-ALL) is a rare disease associated with poor cytogenetics and inferior survival outcomes. In this case series, we present two cases of B-ALL following treatment for invasive ductal carcinoma of the breast and squamous cell carcinoma of the tongue, respectively, along with a third case of B-ALL arising in a patient with chronic lymphocytic leukemia after treatment. The most common cytogenetic abnormalities observed in these patients were t(9;22) and monosomy 7. This case series underscores the importance of recognizing therapy-related B-ALL as a distinct clinical entity, which plays a crucial role in ALL risk classification and the long-term management of both solid and hematologic cancer survivors.