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. Author manuscript; available in PMC: 2019 May 1.
Published in final edited form as: Mod Pathol. 2018 Jan 12;31(5):690–704. doi: 10.1038/modpathol.2017.182

FIGURE 4. Patient 9, Time course of laboratory and histopathologic features in a patient with simultaneously identified BCR-ABL1 and JAK2 V617F. Mixed histomorphologic features with progression to accelerated phase chronic myeloid leukemia followed by allogeneic transplant induced remission.

FIGURE 4

A. Time course of BCR-ABL1 transcript levels (log scale), cytogenetic t(9;22) results (Cyto), JAK2 V617F status, treatment, peripheral blood counts, and bone marrow morphology, Allo Tx = allogeneic transplant. B. Bone marrow core biopsy at initial diagnosis (month 0) showing features of chronic myeloid leukemia and myelofibrosis. Hypercellular (top), markedly increased hypolobated megakaryocytes with clustering (middle, bottom left), increased reticulin fibrosis, grade 3/3 (bottom right). C. Bone marrow core biopsy after 15 months of tyrosine kinase inhibitor therapy (month 15) showing accelerated phase chronic myeloid leukemia. Hypercellular (top), increased myeloblasts (5-10%) (middle), atypical hypolobated megakaryocytes (bottom left), decreased reticulin fibrosis, grade 2/3 (bottom right). D. Bone marrow core biopsy following stem cell transplant (month 23). Normocellular (top), trilineage hematopoiesis, no morphologic evidence of JAK2+ BCR-ABL1+ myeloproliferative neoplasm (middle, bottom left), grade 0/3 reticulin fibrosis (bottom right).