Promyelocytic blast crisis of chronic myelocytic leukemia with both t(9;22) and t(15;17) in M3 cells

A blast crisis with the features of promyelocytic leukemia (M3) occurred during the evolution of chronic myelocytic leukemia (CML) with the t(9;22) translocation. This rare form of transformation was confirmed by means of cytologic and electron microscopic examination. Cytogenetic studies showed two simultaneous translocations t(15;17) and t(9;22) in the promyelocytes. After intensive chemotherapy, a complete remission was obtained and only karyotypes with t(9;22) translocation were present. These data confirm the specificity of the t(15;17) translocation in malignant promyelocytic proliferation and provide evidence for a second genetic event in the genesis of blast crisis occurring in a committed cell belonging to the abnormal population defined by the Ph1 chromosome.