Decitabine-containing G-CSF priming regimen overcomes resistance of primary mediastinal neoplasm from early T-cell precursors to conventional chemotherapy: a case report
| Autor: | Qingxin Xia, Junfeng Chu, Zheng Yan, Fan Zhang, Yuhuan Yang, Zhihua Yao, Haiying Wang, Yanyan Liu, Shuna Yao, Jiuyang Zhang |
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| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Myeloid Decitabine Case Report Stem cell marker G-CSF priming 03 medical and health sciences 0302 clinical medicine Immunophenotyping hemic and lymphatic diseases medicine Pharmacology (medical) business.industry early T-cell precursor medicine.disease Mediastinal Neoplasm Transplantation Leukemia 030104 developmental biology medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Cancer research Stem cell T-lymphoblastic lymphoma business decitabine medicine.drug |
| Zdroj: | OncoTargets and therapy |
| ISSN: | 1178-6930 |
| DOI: | 10.2147/ott.s214905 |
| Popis: | Early T-cell precursor (ETP) leukemia represents a new subtype of T-lymphoblastic leukemia/lymphoma with unique immunophenotypes expressing T-cell and one or more of the myeloid/stem cell markers. Here, we report a young patient who had primary mediastinal mass and pleural effusion without bone marrow involvement. A CT-guided mediastinal biopsy and flow cytometry analysis of the pleural effusion revealed the blast cells to have complicated immunophenotypes: strongly expressed T-cell antigen CD7, myeloid-lineage antigens CD33 and CD13 and stem cell markers cTdT, CD34, and HLA-DR; dimly expressed myeloid-lineage specific antigen cMPO and B-cell antigen cCD79a; but did not express T-cell specific antigen cytoplasmic CD3 and B-cell specific antigen CD19. Clonal T-cell receptor rearrangement eventually determined the cell of origin from ETPs, not myeloblasts. The patient showed primary resistance to lymphoid and myeloid-directed induction therapy. Finally, low-dose decitabine combined with modified-CAG regimen induced a complete remission and allogeneic stem cell transplantation was performed as consolidation. The case indicates a primary mediastinal neoplasm from ETP with distinctive immunophenotype from leukemia type. Low-dose decitabine and modified-CAG regimen in combination with allogeneic stem cell transplantation may improve the outcome of patient. |
| Databáze: | OpenAIRE |
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