Development of acute lympboblastic leukemia in a patient with increased hematogones after toxic bone marrow damage

To the best of our knowledge we describe the first case showing the association of increased B cell precursors/hematogones in a regenerating post-toxic bone marrow with subsequent development of a B-ALL. Since all immunohistochemical/moleculargenetic anaylses have failed to identify the initial malignant leukemic clone, we suggest a close-meshed follow-up of such cases to identify potential mechanisms for the malignant transformation of B-cell precursors/hematogones and to prevent further fatal courses.