Chronic myeloid leukemia in blast phase masquerading as T-lymphoblastic lymphoma with t(22;22) karyotype: a case report

blast phase CML (BP-CML) with mixed phenotype (T-lineage and myeloid expression). The chromosomal karyotype evolved from the initial complex karyotype t(22;22) to t(9;22;22), revealing that the Philadelphia (Ph) chromosome translocation was the initiating event of the disease. The patient achieved molecular remission following chemotherapy with the Hyper-CVAD/MA regimen combined with a tyrosine kinase inhibitor (TKI). This case underscores the importance of differentiating BP-CML among adult Ph-positive T-lymphoblastic neoplasms and highlights the value of multi-platform integrated diagnosis for identifying atypical presentations.