Secondary Chronic Myeloid Leukemia in the Blast Phase With Mixed Phenotype After Radiation Therapy: A Case Report

A 55-year-old woman underwent hysterectomy and pelvic radiation for cervical cancer, which remains in remission. Forty-three months later, she developed secondary CML-BP with CD19+ mixed phenotype (B/myeloid), previously unreported. Following induction therapy, sequential therapy with blinatumomab and ponatinib achieved qualitatively PCR-negative minor BCR::ABL1 transcripts, indicating that residual transcripts below the qualitative assay's detection limit were undetectable. She received an allogeneic bone marrow transplant and remains well with PCR-negative minor BCR::ABL1 at 15 months after transplantation. This sequential therapy suggests a potential utility as a bridge to hematopoietic stem cell transplantation for secondary CML-BP with CD19+ mixed phenotype.