From primary myelofibrosis to chronic myeloid leukemia, + B-Lymphoblastic leukemia, and back to primary myelofibrosis: An illustration of dynamic clonal evolution.

The simultaneous detection of :: and V617F was rarely reported and their clonal relationship and dynamic clonal shift were not characterized. Here, we described a unique case with the initial presentation as V617F+ primary myelofibrosis, followed by the emergence of + chronic myeloid leukemia. The patient then developed B-lymphoblastic leukemia.

p210- Chronic myeloid leukemia presents with monocytosis.

Rare cases of CML present with monocytosis as well as morphologic dysplasia and harbor p210. Cytogenetic and molecular studies must be performed to confirm the diagnosis of this kind of CML.