Double Philadelphia Chromosome-Positive B Acute Lymphoblastic Leukemia

Philadelphia (Ph) chromosome is the derivative chromosome 22 that results from reciprocal translocation t(9;22) (q34;q11). It has been found in about 95% of chronic myeloid leukemia (CML), less often presented in acute lymphocytic leukemia (ALL, about 25% in adult and 2 4% in pediatrics) and occasionally observed in acute myelogenous leukemia (AML) [1]. While double Ph chromosomes can be reported in some cases of CML during blastcrisis, it is rarely reported in ALL. We present a rare case of a lady with a diagnosis of double Ph-positive B-ALL who achieved a continuous complete response after treatment with a combination of conventional chemotherapy and tyrosine kinase inhibitor (TKI) as follows.