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A case of minor BCR-ABL1 positive acute lymphoblastic leukemia following essential thrombocythemia and originating from a clone distinct from that harboring the JAK2-V617F mutation
- Source :
- Experimental Hematology & Oncology
- Publication Year :
- 2014
- Publisher :
- Springer Science and Business Media LLC, 2014.
-
Abstract
- Here we report on a case of Philadelphia chromosome positive B lymphoblastic leukemia (Ph+ALL), which developed following a long duration of essential thrombocythemia (ET). A mutational analysis of Janus Kinase 2 (JAK2) revealed that the V617F mutation was present in granulocytes and in hematopoietic stem and progenitor cells (HSPCs), but not in the CD34+CD19+ population that mostly consists of Ph+ALL cells, indicating that this Ph+ALL clone did not originate from the ET clone carrying the JAK2-V617F mutation. The minor BCR-ABL1 fusion was detected not only in the CD34+CD19+ population but also in HSPCs and granulocytes, indicating that the Philadelphia chromosome was acquired in an early hematopoietic stage at least prior to the commitment to B cell development. Upon dasatinib treatment, the minor BCR-ABL1 transcript rapidly disappeared in HSPCs but persisted in the CD34+CD19+ population. A relapse of Ph+ALL occurred nine months later without the disappearance of the minor BCR-ABL1 transcript in the bone marrow cells during the treatment course, suggesting that a resistant Ph+ALL clone may have arisen or been selected in the committed B cells rather than in HSPCs. This case report may partly contribute to filling the gap between previous data acquired from mice experiments and the phenomenon in real patients.
- Subjects :
- Cancer Research
Population
Clone (cell biology)
Tyrosine kinase inhibitor
Case Report
Resistant clone
Philadelphia chromosome
Myeloproliferative neoplasms
hemic and lymphatic diseases
Medicine
education
B cell
JAK2-V617F
education.field_of_study
Philadelphia Chromosome Positive
business.industry
Hematology
medicine.disease
BCR-ABL1
Lymphoblastic leukemia
Molecular biology
Dasatinib
Haematopoiesis
medicine.anatomical_structure
Oncology
Immunology
Bone marrow
business
medicine.drug
Subjects
Details
- ISSN :
- 21623619
- Volume :
- 3
- Database :
- OpenAIRE
- Journal :
- Experimental Hematology & Oncology
- Accession number :
- edsair.doi.dedup.....e245ab03a5f109c2315ad68076203037