Successful treatment of lymphoid blastic crisis in chronic myelogenous leukemia with the additional bcr/abl transcript using imatinib-combined chemotherapy and high-dose chemotherapy with allogeneic bone marrow stem cell transplantation
| Autor: | Yoshinobu Kanda, Nagako Horikawa, Tomoko Fukudome, Tomoko Hisakata, Shuro Yoshida, Nobuaki Chosa, Kiyoshi Yamashita, Shinya Okuda, Masaki Ito, Ryoko Sakurai, Hiroko Kugimiya, Akira Ueda, Noriaki Kawano |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
medicine.medical_treatment Fusion Proteins bcr-abl Hematopoietic stem cell transplantation Philadelphia chromosome Piperazines Leukemia Myelogenous Chronic BCR-ABL Positive hemic and lymphatic diseases Antineoplastic Combined Chemotherapy Protocols medicine Humans Transplantation Homologous Philadelphia Chromosome neoplasms ABL business.industry Hematopoietic Stem Cell Transplantation breakpoint cluster region Hematology Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease Combined Modality Therapy Leukemia Pyrimidines Treatment Outcome Imatinib mesylate Benzamides Imatinib Mesylate Cancer research Female Blast Crisis business Chronic myelogenous leukemia K562 cells |
| Zdroj: | International Journal of Hematology. 94:561-566 |
| ISSN: | 1865-3774 0925-5710 |
| Popis: | Chronic myelogenous leukemia (CML) is a myeloproliferative disorder characterized by the presence of the Philadelphia chromosome. Although the major BCR/ABL transcript is present in majority of CML patients, the minor BCR/ABL transcript is rarely reported as an additional chromosomal abnormality related to the progression of CML. We describe the case of a 37-year-old woman who had CML and pain in the extremities. She was diagnosed with lymphoid blast crisis of CML on the basis of the following findings: presence of promyelocytes, myelocytes, and metamyelocytes in peripheral blood smear; detection of major and minor BCR/ABL transcripts by polymerase chain reaction analysis; proliferation of lymphoblastic cells with abnormal B-cell phenotype; and aberrant expression of myeloid antigens in the bone marrow. The patient underwent one course of idarubicin and cytosine arabinose therapy combined with imatinib followed by daunorubicin/cyclophosphamide plus vincristine and prednisone/L: -asparaginase (DNR/COP/L: -ASP) therapy, high-dose cytosine arabinose, and CHOP therapy (cyclophosphamide, doxorubicin, vincristine, and prednisolone). Subsequently, the patient underwent high-dose chemotherapy (total body irradiation and cyclophosphamide) followed by allogeneic bone marrow stem cell transplantation from a human leukocyte antigen (HLA)-matched unrelated donor. After these treatments, the patient was disease-free for 19 months. Our case suggests that these treatments may be feasible, safe, and effective for the treatment of patients with blast crisis CML expressing the minor BCR/ABL transcript. |
| Databáze: | OpenAIRE |
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