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


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



19 May 2022 : Case report  Serbia

Bilateral Emphysematous Pyelonephritis Associated with COVID Pneumonia: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.936370  

17 May 2022 : Case report  USA

High-Frequency Oscillatory Ventilation for Refractory Hypoxemia in Severe COVID-19 Pneumonia: A Small Case ...

Am J Case Rep In Press; DOI: 10.12659/AJCR.936651  

13 May 2022 : Case report  Japan

A case of exacerbation of haloperidol-induced rhabdomyolysis following the onset of COVID-19

Am J Case Rep In Press; DOI: 10.12659/AJCR.936589  

13 May 2022 : Case report  USA

Acute Disseminated Encephalomyelitis After SARS-CoV-2 Vaccination

Am J Case Rep In Press; DOI: 10.12659/AJCR.936574  

In Press

23 May 2022 : Case report  Switzerland

Pharmacological and Behavioral Strategies to Improve Vision in Acquired Pendular Nystagmus

Am J Case Rep In Press; DOI: 10.12659/AJCR.935148  

23 May 2022 : Case report  USA

A Case of Methicillin-Sensitive Staphylococcus aureus (MSSA) Prostate Abscess, Osteomyelitis, and Myositis ...

Am J Case Rep In Press; DOI: 10.12659/AJCR.936704  

23 May 2022 : Case report  USA

Adalimumab Mitigates Lumbar Radiculopathy in a Case of Ankylosing Spondylitis

Am J Case Rep In Press; DOI: 10.12659/AJCR.936600  

20 May 2022 : Case report  Canada

Diagnostic Puzzle of Acute Ischemic Stroke Mimics – Seizure Versus Post-Stroke Recrudescence: A Case Report

Am J Case Rep In Press; DOI: 10.12659/AJCR.936826  

Most Viewed Current Articles

23 Feb 2022 : Case report  USA

Penile Necrosis Associated with Local Intravenous Injection of Cocaine

DOI :10.12659/AJCR.935250

Am J Case Rep 2022; 23:e935250

17 Feb 2022 : Case report  Oman

Myocarditis, Pulmonary Hemorrhage, and Extensive Myositis with Rhabdomyolysis 12 Days After First Dose of P...

DOI :10.12659/AJCR.934399

Am J Case Rep 2022; 23:e934399

06 Dec 2021 : Case report  Brazil

Lipedema Can Be Treated Non-Surgically: A Report of 5 Cases

DOI :10.12659/AJCR.934406

Am J Case Rep 2021; 22:e934406

19 Feb 2022 : Case report  USA

A Rare Case of Coronavirus Disease 2019 Vaccine-Associated Cerebral Venous Sinus Thrombosis Treated with Me...

DOI :10.12659/AJCR.935355

Am J Case Rep 2022; 23:e935355

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