Case report: BCR-ABL-positive acute lymphoblastic leukemia with bone destruction: a treatment dilemma
| Autor: | Shi Lijun, Ma Zhongrui, Wei Li, Yu Xia, Jiang Wei, Pan Yaning |
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| Jazyk: | angličtina |
| Rok vydání: | 2024 |
| Předmět: | |
| Zdroj: | Frontiers in Oncology, Vol 14 (2024) |
| Druh dokumentu: | article |
| ISSN: | 2234-943X 74407724 |
| DOI: | 10.3389/fonc.2024.1356311 |
| Popis: | Although bone destruction and hypercalcemia without acute peripheral blast BCR-ABL-positive acute lymphoblastic leukemia (ALL) have been reported in children, they are rare in adults. Herein, we describe a case of BCR-ABL positive ALL with a triploid karyotype, WT1, and CDKN2A mutations with hypercalcemia and bone destruction as the first manifestations. Complete remission (CR) was achieved by induction chemotherapy. BCR-ABL turned negative after treatment with dasatinib. However, computed tomography and whole-body bone scan showed extensive bone destruction. Additionally, bone biopsy showed leukemic infiltration. After treatment with dasatinib and VMCP, leukemia recurred with positive BCR-ABL. The T315I mutation occurred. The patient was surgically diagnosed with calculous cholecystitis and achieved CR2 by postoperative orebatinib and VP regimens. Later, the patient died due to a severe pulmonary infection. BCR-ABL-positive ALL with bone destruction is rare and difficult to control using tyrosine kinase inhibitor chemotherapy alone. Therefore, further exploration of more effective treatments is needed. |
| Databáze: | Directory of Open Access Journals |
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