De novo acute myeloid leukemia harboring concomitant t(8;21)(q22;q22);RUNX1::RUNX1T1 and BCR::ABL1 (p190 minor transcript)

De novo AMLs with typical nonrandom chromosomal abnormalities are often associated specific morphology subtypes. The t(8;21) is one of the most prominent recurrent cytogenetic aberrations (RCA) in AML, frequently AML maturation, and characterized as a good prognostic marker. On contrary, BCR::ABL1 rearrangement rarely observed AMLs, without morphology, carrying poor prognosis. Its distinction from blastic transformation chronic myeloid leukemia has been matter long debate. revised WHO classification (2016) recognized BCR::ABL1+ provisional entity. occurrence additional RCA within same leukemic clone detected, albeit rare cases were reported, mainly subclones. Those molecular findings seem to significantly affect patient Conventional analysis, fluorescent situ hybridization (FISH), polymerase chain reaction (PCR) applied at presentation during follow-up patient. We present 34-year-old male de harboring concomitant t(9;22) single clone. presence both Philadelphia chromosome (Ph+) metaphases but less than 100% analyzed cells, p190 BCR::ABL transcript type, absence splenomegaly support that part main These findings, accompanied an encouraging outcome continuous remission after induction therapy, being secondary genetic event t(8;21).