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Abstract Introduction Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and positive sinonasal bacterial cultures may be recalcitrant to topical therapy alone due to the additional local inflammatory burden associated with bacterial infection/colonization. Objectives To evaluate sinonasal outcomes in CRSwNP patients with a positive perioperative bacterial culture, who were treated with postoperative intranasal corticosteroids (INCS) alone versus INCS in combination with a short-term course of oral corticosteroids (OCS). Methods This is a retrospective chart review of CRSwNP patients. A total of 59 patients met inclusion criteria, including positive perioperative bacterial culture and treatment with INCS with or without concomitant use of OCS. Two cohorts were formed based on the chosen postoperative medical treatment; 32 patients underwent postoperative INCS alone, while 27 underwent INCS plus a ≤ 2-week course of OCS. The 22-item sinonasal outcome test (SNOT-22) scores and Lund-Kennedy scores (LKS) were assessed preoperatively, and at 2-week, 4-week, and 4 to 6 months after endoscopic sinus surgery (ESS). Results There were no statistically significant differences in postoperative sinonasal symptoms or endoscopic scores between the cohorts treated with INCS plus OCS versus those prescribed INCS alone (p > 0.05). Our regression model failed to demonstrate a relationship between the use of OCS and better sinonasal outcomes at 2-week, 4-week, and 4 to 6 months after ESS (p > 0.05). Conclusions Our study suggests that in a cohort of CRSwNP patients with recent bacterial infections, the postoperative use of combined OCS and INCS did not result in a statistical improvement of endoscopic and symptomatic outcomes over INCS irrigation alone. However, both treatment groups had a clinically significant improvement based on the Minimal Clinically Important Difference.
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Chronic myeloid leukemia with a significant increase of monocytes is rare and difficult to identify from chronic myelo-monocytic leukemia in clinic. A 31-year-old male patient with systemic pain was initially diagnosed as chronic myelo-monocytic leukemia, who was finally diagnosed as chronic myeloid leukemia by fusion gene and chromosome examination. In addition to the typical Ph chromosome, a rare chromosome translocation t(2; 7)(p13; p22) was observed. The detection of monocyte subsets by multi-parameter flow cytometry is a diagnostic marker to distinguish the above 2 diseases. The relationship between fusion genes and mononucleosis is not clear. Tyrosine kinase inhibitors or allogeneic hematopoietic stem cell transplantation can be used in the treatment for this disease.
Subject(s)
Adult , Humans , Male , Karyotype , Karyotyping , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics , Monocytes , Translocation, GeneticABSTRACT
Resumen Introducción: La rinosinusitis crónica (RSC) tiene un alto impacto en la calidad de vida del paciente. La recomendación de las guías EPOS es utilizar la encuesta Sino-Nasal-Outcome-Test de 22 indicadores (SNOT-22), la cual no está validada en población chilena. Objetivo: Traducción y validación de SNOT-22 en población chilena consultante por RSC en el Servicio de Otorrinolaringología del Hospital del Salvador. Material y Método: Traducción de SNOT-22, reclutamiento de pacientes con y sin RSC. Aplicación de versión traducida en dos ocasiones con dos semanas de diferencia. Evaluación de validez de constructo y discriminante. Resultados: Se evaluaron 34 pacientes sin RSC y 16 con RSC. El puntaje total promedio de SNOT-22 fue 19,62 y 43,1 puntos, con diferencias significativas entre ambos grupos. Respecto a la validación, se observó un coeficiente alfa Cronbach > 0,95, un coeficiente de correlación intraclase de 0,986, un coeficiente de correlación de Pearson de 0,84 y un área bajo la curva ROC de 0,861. Conclusión: La traducción y adaptación transcultural de esta versión de SNOT-22 es válida y confiable. Esta versión de SNOT-22 es un buen instrumento para evaluar el impacto de RSC y su intervención en la calidad de vida de pacientes adultos chilenos.
Abstract Introduction: Chronic rhinosinusitis has a high impact on the patient's quality of life. The recommendation of the EPOS guidelines is to use the Sino-Nasal-Outcome-Test sur- vey of 22 indicators (SNOT-22), which is not validated in the Chilean population. Objective: translation and validation of SNOT-22 in Chilean population consulting for CRS in the ENT department of the Hospital del Salvador. Material and Method: translation of SNOT-22. Recruitment of patients with and without CRS. Application of translated version two times two weeks apart. Evaluation of discriminant validity and construct validity. Results: 34 patients without CRS and 16 with CRS were evaluated. The average total SNOT-22 score was 19.62 and 43.1 points, respectively, with significant differences between both groups. Regarding validation analysis, Cronbach's alpha coefficient observed was > 0.95, intraclass correlation coefficient was 0.986, Pearson's correlation coefficient was 0.84 and the area under the ROC curve was 0.861. Conclusion: The translation and transcultural adaptation of this version of SNOT-22 is valid and reliable. This version of SNOT-22 is a good instrument to assess the impact of CSR, and its intervention, on the quality of life of Chilean adult patients.
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Abstract Introduction: Chronic rhinosinusitis can lead to poor sleep quality in affected individuals. Endoscopic nasal surgery has been indicated for patients with chronic rhinosinusitis, resulting in improved quality of life, but it is still unknown if there is a similar improvement in sleep quality after the surgical procedure. Objective: To estimate the sleep quality of patients with chronic rhinosinusitis after undergoing endoscopic sinus surgery. Methods: The literature search was conducted in the indexed databases PubMed, Embase, Lilacs, SciELO, Google Scholar, Web of Science, Scopus, Database of Thesis and Dissertations of CAPES, Cochrane Library, Clinical Trials and in the grey literature. It included studies that reported the sleep quality of patients with chronic rhinosinusitis after undergoing endoscopic sinus surgery based on questionnaires assessing quality of life. Two researchers independently conducted the study selection and extraction. The random effects model was chosen to conduct the meta-analysis that was performed using the statistical package STATA, version 11. Results: Overall, 4 studies and 509 subjects were included in the systematic review. Improved sleep quality was observed in 90% of the patients. There was an improvement (on average, from 57% to 67%) in each of the five symptoms related to sleep quality. The results of the meta-analysis revealed high heterogeneity. Conclusions: This review shows that a large percentage of patients report improved sleep quality after endoscopic sinus surgery.
Resumo Introdução: A rinossinusite crônica pode levar a uma má qualidade do sono nos indivíduos afetados. A cirurgia endoscópica nasal tem sido indicada para pacientes com rinossinusite crônica, resulta em melhoria da qualidade de vida, mas ainda não se sabe se há melhoria semelhante na qualidade do sono após o procedimento cirúrgico. Objetivo: Estimar a qualidade do sono em pacientes com rinossinusite crônica após serem submetidos à cirurgia endoscópica nasossinusal. Método: A busca na literatura foi feita nas bases de dados indexadas PubMed, Embase, Lilacs, SciELO, Google Scholar, Web of Science, Scopus, Banco de Teses e Dissertações da Capes, Cochrane Library, Clinical Trials e na literatura cinzenta. Foram incluídos estudos que relataram a qualidade do sono de pacientes com rinossinusite crônica após ser submetidos à cirurgia endoscópica nasossinusal, com base em questionários que avaliaram a qualidade de vida. Dois pesquisadores conduziram independentemente a seleção e extração dos estudos. O modelo de efeitos aleatórios foi escolhido para conduzir a meta-análise que foi feita com o pacote estatístico STATA, versão 11. Resultados: No total, 4 estudos e 509 indivíduos foram incluídos na revisão sistemática. Melhora na qualidade do sono foi observada em 90% dos pacientes. Houve melhora (em média, de 57% a 67%) em cada um dos cinco sintomas relacionados à qualidade do sono. Os resultados da meta-análise apresentaram alta heterogeneidade. Conclusões: Esta revisão mostra que uma grande porcentagem de indivíduos relata melhoria na qualidade do sono após a cirurgia endoscópica nasossinusal.
Subject(s)
Humans , Sinusitis/surgery , Sleep/physiology , Rhinitis/surgery , Endoscopy/methods , Quality of Life , Nasal Polyps/surgery , Chronic Disease , Surveys and Questionnaires , Nasal Surgical ProceduresABSTRACT
Objective To investigate the association between interleukin-22 (IL-22) single nucleotide polymorphisms (SNPs) and the prognosis of hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF).Methods The patients with HBV-ACLF from the First Affiliated Hospital of Fujian Medical University were retrospectively studied.Seven SNP genotypes of IL-22 gene,including rs2227478,rs2227491,rs1179251,rs1179249,rs2227473,rs2227484,and rs11611206,were detected using imLDRTM multiple SNP typing kit and the distribution features of SNP genotypes were described.The relationship between the distribution of SNP genotypes and alleles and the prognosis of ACLF was analyzed.Comparison of genotypes and allele frequencies between groups were performed by chi-square test of R × C table or Fisher's exact tests.Binary logistic regression analysis was used to analyze whether IL-22 gene polymorphisms was an independent prognostic factor for patients with ACLF.Results A total of 122 patients with HBV-ACLF were included in this study.Ninety-two (75.1％) were male and 30 (24.59 ％) were female.Patients were stratified as survival group (90 cases) and non-survival group (32cases) according to the Results of three months follow-up.The genotype distribution of rs2227484 of IL-22 gene was significantly different between the two groups (x2=6.128,P=0.033).The A allele frequency in the non-survival group (15.6％) was significantly higher than that in the survival group (5.6％) with statistically significance (OR=0.318,95％ CI=0.126-0.804,P=0.012).There was no significant difference in the other six SNP genotypes of IL-22 gene between the two groups (all P＞0.05).However,binary logistic regression showed that rs2227484 of IL-22 gene was not an independent risk factor for the short-term mortality in HBV-ACLF patients (adjusted OR=3.102,95％ CI:0.939-10.250,P=0.063).Conclusions The A allele and AA genotype of rs2227484 of IL-22 gene may be associated with a short-term prognosis in patients with HBV-ACLF.
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Objective To compare the clinical efficacy of acupuncture and medicine for the treatment of chronic pharyngitis. Methods Sixty chronic pharyngitis patients were randomized into treatment group and control group, 30 cases in each group. The treatment group was treated with acupuncture mainly on acupoints of Zhaohai(KI6), Lieque(L7), Tiantu(CV22) , Lianquan(CV23), Tianrong(SI17) , Hegu(LI), Yuji (LU10) for nourishing yin to reduce fire and clearing throat. The supplementary acupoints were selected according to the symptoms and physical signs. Acupuncture was performed once a day and 6 times a week. The control group received western medical therapy including pharyngeal application with 1% iodine glycerin preparation and oral use of Cydiodine tablets, 3 times per day. Four weeks constituted one treatment course and the treatment for the two groups covered 2 courses. After treatment, the therapeutic effect was evaluated. The scores of the signs and s ymptoms as well as scores of chronic pharyngitis syndrome discomfort rating questionnaire(CPSDQ) evaluated by visual anal og scale(VAS) were observed. Results (1) The overall effective rate of the treatment group was 93.3%, higher than that of the control group(73.3%), and the inter-group difference was statistically significant (P<0.05). (2) After treatment, scores of the signs and symptoms and VAS for CPSDQ scores in the two groups were reduced as compared with those before treatment(all P<0.05 or P<0.01 ) .The improvement of the scores in the treatment group was superior to that in the control group(all P<0.05 or P<0.01).(3) During the treatment , needling-induced mild pain and bleeding occurred in the treatment group. No acupuncture syncope, stuck needles or allergic and toxic-side effect was shown in the two groups. Conclusion Acupuncture therapy can obviously relieve the symptoms, signs and discomfort in the patients with chronic pharyngitis, and the curative effect is superior to the drugs.
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Objective To investigate the potential of chronic myeloid leukemia ( CML) cell line KCL22 in indu-cing leukemia in NOD-SCID mice for setting up a basis for constructing a CML mouse transplantation tumor model. Methods 2 ×107 KCL22 cells in logarithmic growth phase were injected via the tail vein into experimental NOD-SCID mice whereas PBS was injected to the mice of control group.General condition of the mice of both groups was observed.Wright staining was used to observe the changes of blood and bone marrow smears.PCR was conducted to detect the transcription level of BCR-ABL, and histology with HE staining was used to evaluate the tumor cell invasion in the liver and spleen. Results Four weeks after the injection of KCL22 cells, the mice in experimental group showed physical signs of decreased reactivity, depression, swollen hindlimb muscles and petechia on the hindlimb femur.Peripheral white blood cells ( WBC) began to increase after 5 weeks, with a significantly increased quantity compared with the control group (P90 days) (P<0.05).Conclusions A NOD-SCID mouse model of CML transplantation tumor is successfully established with leukemia KCL22 cells.
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Objective To analyze the influence of SH3 domain mutant (ABL SH3-T79Y) in BCR-ABL protein of chronic myeloid leukemia (CML) in combination with imatinib (IM) on the proliferation of CML cells in vivo and vitro, and to discuss the mechanism thereof. Methods Recombinant ABL SH3-T79Y mutant adenovirus vectors which were successfully constructed in previous work was used with IM to treat K562/G01 cells, then the cell-colony forming ability of K562/G01 cells was determined by clone formation assay, and cell cycle was assessed by flow cytometry. KCL22 cells were treated by recombinant SH3-T79Y and IM to construct subcutaneous solid tumor model in Balb/c nude mice, then the formation rate of subcutaneous tumor was estimated, the pathological examination was conducted, and the proliferation ability of KCL22 cells was assayed. K562/G01 cells were treated by SH3-T79Y and IM in combination, and the expression levels of p-BCR-ABL, BCR-ABL, p-CrkL, CrkL and Cyclin-D1 protein were determined by Western blotting. Cells treated with PBS, null recombinant adenovirus vectors or IM alone served as control groups. Results Compared to the 3 control groups, clone forming rate of K562/G01 cells decreased significantly (P<0.05) and cell cycles were arrested at S phase after being combined SH3-T79Y and IM treatment. The subcutaneous solid tumor formation rate in KCL22- Balb/c nude mice was 16.7% after combined SH3-T79Y and IM treatment, and large number of tumor cells were observed in tumor pathology examination. Western blotting revealed that the expression levels of p-BCR-ABL, p-CrkL, BCR-ABL, CrkL and Cyclin-D1 were decreased in K562/G01 cells. Conclusion Combined treatment of SH3-T79Y and imatinib may inhibit the proliferation of CML cells in vivo and in vitro by decreasing BCR-ABL and CrkL phosphorylation as well as Cyclin-D1 protein.
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Objective To establish a real -time quantitative PCR ( RT-PCR) assay for detecting serum miR -122, miR-22, and evaluate the clinical significance of miR -122 and miR-22 in patients with chronic hepatitis B ( CHB) by using of this assay .Meth-ods The mature miRNAs were reversely transcripted by using of stem -loop primers .SYBR GreenⅠquantitative real-time PCR ( qRT-PCR) was used for quantification of the miRNAs .The sensitivity of this assay was evaluated by using of the 10-fold-diluted miRNA-122 cDNA standards and the specificity was verified by using of melting curve assay .The accuracy was assessed by intra -assay coeffi-cient of variation (CV) of threshold cycle (Ct value), which were calculated from a 20-times-repeat detection of the miR -122 cDNA (2 ×105 , 2 ×106 , 2 ×107 copies/μl) standards.Using the established qRT -PCR assay, we detected the expression of serum miR -122 and miR-22 in the patients with CHB and healthy controls .Results The qRT-PCR assay exhibited good performances in the linear range, sensitivity and reproducibility while detecting miR -122 and miR-22.The relative level of miR -122 and miR-22 was 17.88 vs 5.35 in the CHB patients and 1.80 vs 1.67 in the controls (P=0.000).Conclusion Using of stem-loop primers, we established a qRT-PCR assay for detection of serum miR -122 and miR-22.Serum miR-122 and miR-22 increased significantly in the CHB pa-tients.
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BACKGROUND: The coexistence of t(9;22)(q34;q11.2) and inv(16)(p13q22) chromosomal abnormalities is extremely uncommon, and only a small number of such cases have been reported. Here, we characterized 7 cases of hematologic malignancy exhibiting t(9;22) and inv(16) coexistence. METHODS: We reviewed the cytogenetic data for hematologic malignancies treated at the Catholic Blood and Marrow Transplantation Center between January 2004 and June 2013. We identified 7 cases exhibiting t(9;22) and inv(16) coexistence. In addition, we analyzed mutations in the IKZF1, NPM1, FLT3, N-RAS, K-RAS, c-KIT, and TP53 genes. RESULTS: Four cases of chronic myelogenous leukemia (CML; 1 chronic phase, 2 accelerated phase, and 1 blast phase) and 3 cases of acute myeloid leukemia (AML; 1 de novo and 2 therapy-related) were identified. The percentages of circulating blasts and bone marrow eosinophils were higher in AML cases than in CML cases (53% vs. 5% and 30% vs. 5.5%, respectively). The proportions of each chromosomal abnormality were used along with follow-up karyotyping results to identify secondary changes. In BCR/ABL, a p210 fusion transcript was associated with CML, whereas a p190 fusion transcript was associated with AML. One patient with AML harbored 2 mutations: c-KIT D816V and TP53 E11Q. All patients except 1 with CML blast phase sustained clinical remission after treatment, which included an imatinib mesylate regimen. CONCLUSION: This study shows that observations of bone marrow morphology, initial and follow-up cytogenetic studies, and karyotyping of BCR/ABL1 and CBFB/MYH11 provide valuable information for characterizing hematologic malignancies exhibiting t(9;22) and inv(16) coexistence.
Subject(s)
Humans , Blast Crisis , Bone Marrow , Chromosome Aberrations , Cytogenetics , Eosinophils , Follow-Up Studies , Genes, p53 , Hematologic Neoplasms , Karyotyping , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Leukemia, Myeloid, Acute , Mesylates , Imatinib MesylateABSTRACT
Objective To investigate whether a novel long-acting tumor necrotic factor (TNF) antagonist (soluble TNF receptor:IgG Fc [sTNFR:IgG-Fc]) can protect hepatocyte damage against liver failure caused by drugs in immunity-induced cirrhotic rats.Methods Wistar rats were repeatedly sensitized by human serum albumin (HSA) emulsified in complete freud adjuvant.The blood was collected at day 10 after the final sensitization.If anti-albumin antibody was positive,the rats were intravenously injected with HSA twice a week.After six weeks,liver cirrhosis was induced by immunity.All the model rats were divided into three groups with 15 each.Liver failure was induced with D-galactosamine/ lipopolysaccharide (LPS) intraperitoneal injection in the rats with liver cirrhosis in model group.The rats in pretreatment group were intraperitoneally injected with long-acting soluble TNF receptor p55 18 h before D-galactosamine/LPS injection.The control group were injected with 0.9％ sodium chloride.General condition,survival rate,liver function and pathological changes were all examined.Serum levels of interleukin (IL)-6,IL-22 and intrahepatic level of IL-6 were detected by enzyme linked immunosorbent assay (ELISA).The activity of Caspase 3 in hepatocyte lysis solution was measured by spectrophotography.Real-time polymerase chain reaction (PCR) was used to detect mRNA expressions of proliferating cell nuclear antigen (PCNA),bcl-2,bax and IL-22 receptor.Data were analyzed by variance analysis among groups.Results Rats in model group were dispirited with poor response after 12 hours and only 3 survived,compared with soluble TNF receptor p55 pre-treated group rats,in which all survived (P=0.029 8) with flexible response.Serum alanine aminotransferase levels in these two groups were (6 533± 360) and (105 ± 7) U/L,respectively.Hepatic regenerative nodule developed massive or submassive necrosis with septal fibrosis in model group,whereas soluble TNF receptor p55 alleviated the inflammatory and necrosis reaction of hepatic tissue.Serum IL-6 levels in model group and pretreatment group were (842.0±12.9) and (91.9±1.6) pg/mL,respectively (F=380.30,P＜0.01).Intrahepatic levels of IL-6 in these two groups were (26.2±1.2) and (11.1±0.8) pg/mL,respectively (F=176.90,P＜0.01),and serum IL-22 levels were (167.0±27.8) and (988.0±109.6) pg/mL,respectively (F=37.91,P＜0.01).Hepatic Caspase-3 activity was reduced by almost 60％ by soluble TNF receptor p55 pretreatment (F=303.70,P＜0.01) and bax expression reduced by 22％ (F=108.80,P＜0.01),while bcl-2 and PCNA expressions were up-regulated by 3.6-folds and 23.0-folds,respectively (F=115.60,P＜0.01; F=594.20,P＜0.01).Conclusions Long acting soluble TNF receptor p55 could improve survival rate,liver function and reduce inflammatory reaction of rats with liver failure induced by drugs on the basis of liver cirrhosis caused by immunity,which indicates that this drug may process a potential therapeutic value.
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Chronic granulomatous disease (CGD) is a rare inherited disorder of a defective NADPH oxidase enzyme, resulting in very low or no production of superoxide and subsequent reactive oxygen species. Consequently, patients with CGD are highly susceptible to severe bacterial and fungal infections. CGD is a genetically heterogeneous disease caused by defects in any one of the genes encoding the NADPH oxidase components. CGD generally affects about 3-4 per 1,000,000 individuals; thus, it is surprising that the prevalence of CGD on Jeju Island is 34.3 per 1,000,000 individuals. At present, 20 patients with CGD from 14 unrelated families on Jeju Island have been identified; nine males and 11 females. All patients with CGD tested on Jeju Island had an identical and homozygous mutation (c.7C>T in CYBA, p.Q3X in p22phox). Therefore, all patients were autosomal recessive form of CGD. This strongly suggests that the unique and identical mutation in CYBA may be inherited from a common proband. Using mutation-specific primers to detect the mutated allele in CYBA, the frequency of subjects carrying a mutated allele was 1.3% of enrolled subjects from Seogwipo City. Further studies are necessary to elucidate how frequently this mutant allele occurs in the population on Jeju Island. Additionally, it is important to construct a national registry system to understand the pathophysiology of CGD and develop a strategy for long-term therapy.
Subject(s)
Female , Humans , Male , Alleles , Granulomatous Disease, Chronic , Korea , Lifting , NADPH Oxidases , Prevalence , Reactive Oxygen Species , SuperoxidesABSTRACT
We report a case of chronic myelogenous leukemia displaying a variant Philadelphia translocation t(11;22)(q25;q11.2). Breakpoint 11q25 has not previously been reported. Reverse transcriptase polymerase chain reaction and fluorescence in-situ hybridization demonstrated the BCR/ABL rearrangement.
Subject(s)
Fluorescence , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Reverse Transcriptase Polymerase Chain ReactionABSTRACT
The erythroleukemic blast crisis in chronic myelogenous leukemia (CML) is rarely reported. We present two cases of erythroleukemic blast crisis of CML. In both cases, they had been treated with interferon and hydroxyurea prior to a blast crisis of CML. On blastic transformation, one patient underwent an acute clinical transformation marked with fever and hematochezia but the other showed no clinical deterioration. The blasts appeared in the peripheral blood. The bone marrow aspirates revealed megaloblastic erythroid hyperplasia (about 72%, 54% of all nucleated cells), increasing the number of myeloblasts (about 46%, 59% of all non-erythroid cells), and erythroblasts with a positive PAS stain. The cytogenetic studies revealed Philadelphia chromosomes with additional chromosomal abnormalities, t(3;21)(q26;q22) and the FISH studies revealed bcr-abl fusion signals in bone marrow cells. One case expired 8 months later despite of hydroxyuria therapy. The other case received allogeneic bone marrow transplantation (alloBMT) without complete remission but expired 34 weeks after alloBMT due to GVHD.
Subject(s)
Humans , Blast Crisis , Bone Marrow , Bone Marrow Cells , Bone Marrow Transplantation , Chromosome Aberrations , Cytogenetics , Erythroblasts , Fever , Gastrointestinal Hemorrhage , Granulocyte Precursor Cells , Hydroxyurea , Hyperplasia , Interferons , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , MegaloblastsABSTRACT
Although occasional patients with chronic myeloid leukemia (CML) have chromosomal changes other than Philadelphia chromosome early in the disease, in typical cases the 9;22 translocation remains the sole abnormality throughout the disease course in chronic phase. When disease progression occurs, however, 75-80% develop additional chromosome aberrations. These secondary changes sometimes precede the more aggressive manifestations hematologically and clinically and thus may serve as valuable prognostic indicators. ider (9) (q10)t (9;22) (q34;q11.2) is very rare and a recurrent chromosomal abnormality associated with acute lymphoblastic leukemias (ALL) and lymphoblastic crisis of CML. And ider (9) (q10)t (9;22) (q34;q11.2) is a lymphoid-specific rearrangement and the patients with this abnormality are of older age on average. They commonly show pre-B cell lineage immunophenotype and L2 morphology. We report a case of ider (9) (q10)t (9;22) (q34;q11.2) as secondary aberration in a patient with lymphoblastic crisis of CML.