Concurrent B-cell acute lymphoblastic leukemia and plasma cell neoplasm with plasmablastic features supporting divergent evolution from a shared precursor: a case report - Summary - MDSpire

Concurrent B-cell acute lymphoblastic leukemia and plasma cell neoplasm with plasmablastic features supporting divergent evolution from a shared precursor: a case report

  • By

  • Antonija Babić

  • Ivana Franić Šimić

  • Josip Knežević

  • Koraljka Gjadrov Kuveždić

  • Ivana Ilić

  • Ida Ivek

  • Lara Divjak

  • Alojzija Brčić

  • Klara Bardač

  • Dora Višnjić

  • Radovan Vrhovac

  • Vilma Dembitz

  • Drago Batinić

  • Hrvoje Lalić

  • July 10, 2026

  • 0 min

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Objective:

To report a rare case of simultaneous B-cell acute lymphoblastic leukemia (B-ALL) and plasma cell neoplasm (PCN) and to describe the clonal architecture and evolutionary pathways of these malignancies.

Approach:
  • Case Presentation: A 76-year-old man was diagnosed with B-ALL and a distinct population of aberrant plasma cells identified through flow cytometry. Follow-up analyses confirmed the coexistence of both malignancies, and genomic analysis indicated they were clonally related.
Key Findings:
  • The patient had both B-ALL with a pre-B phenotype and a clonal plasma cell population.
  • Initial treatment for B-ALL induced remission of both components.
  • Subsequent relapse showed expansion of the plasmablastic/plasma cell population consistent with PCN, while B-ALL was undetectable.
  • Genomic analysis supported the presence of two clonally related but distinct malignancies.
Interpretation:

The findings suggest early clonal divergence from a common progenitor rather than independent malignancies or linear differentiation.

Limitations:
  • The case is based on a single patient, limiting generalizability.
  • Further studies are needed to understand the mechanisms of clonal evolution in B-cell malignancies and the implications of such cases.
Conclusion:

This case highlights the complexity of clonal evolution in B-cell malignancies.

Original Source(s)

Concurrent B-cell acute lymphoblastic leukemia and plasma cell neoplasm with plasmablastic features supporting divergent evolution from a shared precursor: a case report

  • by Antonija Babić, Ivana Franić Šimić, Josip Knežević, Koraljka Gjadrov Kuveždić, Ivana Ilić, Ida Ivek, Lara Divjak, Alojzija Brčić, Klara Bardač, Dora Višnjić, Radovan Vrhovac, Vilma Dembitz, Drago Batinić, Hrvoje Lalić

  • July 10, 2026

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