Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

09 April 2009

Molecular and phenotypic variability in consecutive blast crises in CML patient

Krzysztof Lewandowski, Marta Baranska, Michal Gniot, Lidia Gil, Anna Czyz, Małgorzata Iwoła, Mieczyslaw Komarnicki

Am J Case Rep 2009; 10:39-43 :: ID: 869622

Abstract

Background: The mechanisms of chronic myeloid leukemia (CML) transformation into a blast crisis (BC) are not fully understood.
Case Report: We report a case of an acute myeloid leukemia with normal karyotype successfully treated with autologous stem cell transplantation (SCT). Two years later the patient developed CML (p210BCR-ABL positive) that was treated with imatinib. BCs of changing immunophenotype (biphenotypic, biclonal, myeolomonoblastic, monoblastic, myeloblastic) were diagnosed in the next four years. CML was treated with allogeneic SCT from an unrelated donor. In the post-transplant period a disappearance of p210BCR-ABL and conversion to p190BCR-ABL was documented. Moreover, a molecular study of p210 transcript revealed the presence of F311L mutation. Sequencing of p190BCR-ABL has shown a presence of both mutant (F311L) and native BCR-ABL. Three months after the transplantation hematological remission was lost and symptoms of BC resistant to dasatinib were documented.
Conclusions: We hypothesize that p190 has been derived from the existing p210 Philadelphia chromosome. It would be possible if a deletion of 36–92 kb fragment from the Philadelphia chromosome (BCR exons 2-14 and a part of intron 1) occurred, however the alternative splicing seems to be more probable explanation. It cannot be also excluded that p210BCR-ABL and p190BCR-ABL originated from different subclones of leukemic cells. This may confirm the oligoclonality of CML in presented case.

Keywords: blast crises, chronic myeloid leukemia, phenotypic and genotypic variability, Stem Cell Transplantation, tyrosine kinase inhibitors

0 Comments

SARS-CoV-2/COVID-19

26 November 2021 : Editorial  USA

Editorial: SARS-CoV-2 Vaccine Responses and Breakthrough COVID-19

Med Sci Monit In Press; DOI: 10.12659/MSM.935624  

26 November 2021 : Case report  Poland

Arteritic Anterior Ischemic Optic Neuropathy in the Course of Giant Cell Arteritis After COVID-19

Am J Case Rep In Press; DOI: 10.12659/AJCR.933471  

26 October 2021 : Case report  USA

Progressive Pulmonary Fibrosis After Non-Critical COVID-19: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.933458  

25 November 2021 : Case report  USA

A Case of COVID-19-Associated Free-Floating Aortic Thrombus Successfully Treated with Thrombectomy

Am J Case Rep 2021; 22:e933225

In Press

27 Nov 2021 : Case report  Saudi Arabia

Acute Perforated Appendicitis Associated with Appendiceal Diverticulitis in a Young Man: A Case Report with...

Am J Case Rep In Press; DOI: 10.12659/AJCR.934838  

26 Nov 2021 : Case report  Japan

A Case of Metaplastic Squamous Cell Carcinoma of the Breast that Showed a Pathological Complete Response Af...

Am J Case Rep In Press; DOI: 10.12659/AJCR.935035  

26 Nov 2021 : Case report  Poland

Arteritic Anterior Ischemic Optic Neuropathy in the Course of Giant Cell Arteritis After COVID-19

Am J Case Rep In Press; DOI: 10.12659/AJCR.933471  

25 Nov 2021 : Case report  Kuwait

A Well-Differentiated Grade-3 Neuroendocrine Tumor in the Ascending Colon: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.933792  

Most Viewed Current Articles

15 Aug 2020 : Case report  USA

A 57-Year-Old African American Man with Severe COVID-19 Pneumonia Who Responded to Supportive Photobiomodul...

DOI :10.12659/AJCR.926779

Am J Case Rep 2020; 21:e926779

09 May 2019 : Case report  USA

A Rare Case of Stage IV Basaloid Squamous Cell Cancer with Intrapulmonary and Brain Metastases

DOI :10.12659/AJCR.915073

Am J Case Rep 2019; 20:664-667

13 Mar 2019 : Case report  USA

Dry Beriberi Due to Thiamine Deficiency Associated with Peripheral Neuropathy and Wernicke’s Encephalopathy...

DOI :10.12659/AJCR.914051

Am J Case Rep 2019; 20:330-334

09 Jan 2019 : Case report  Saudi Arabia

3-M Syndrome: A Local Case Report

DOI :10.12659/AJCR.912736

Am J Case Rep 2019; 20:36-38

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923