Variant Philadelphia Chromosome: A Report of Two Cases at the Moulay El Hassan Military Hospital, Guelmim

Introduction: Chronic myeloid leukemia (CML) is a malignant hematologic disorder characterized by the t (9;22) chromosomal translocation, forming the Philadelphia chromosome. In rare instances, complex translocations involving other chromosomes, such as t(3;9;22), are observed. This study presents two clinical cases of CML with this cytogenetic abnormality, diagnosed at the Moulay El Hassan Military Hospital in Guelmim. Methodology: Patients were examined for symptoms suggestive of CML, such as chronic fatigue, splenomegaly, and hematologic abnormalities. Cytogenetic and molecular analyses were performed to identify chromosomal abnormalities. Results: Both cases demonstrate the impact of complex translocations on diagnosis and management. Cytogenetic data, in addition to clinical findings, guided treatment with tyrosine kinase inhibitors. Discussion: Complex translocations are associated with diagnostic and therapeutic challenges. A literature review shows that these abnormalities influence treatment response and prognosis, although further data are needed to consolidate these observations. Conclusion: This study illustrates the importance of detailed cytogenetic evaluation in the management of CML, particularly for complex translocations such as t(3;9;22).