Drug resistance of secondary acute myeloid leukemia with megakaryoblastic features and p190 BCR-ABL rearrangement.
A 46-year-old female presented with acute myeloid leukemia during complete remission of multiple myeloma after extensive treatment with alkylating agents. Leukemic blasts expressed CD34, platelet esterase and gp IIIa. RT-PCR analyses of peripheral blood cells detected a p190 type BCR-ABL rearrangement and high levels of MDR1. The patient expired during neutropenia shortly after induction chemotherapy. Autopsy revealed persistent blasts in the bone marrow, spleen and liver. 'Secondary' acute myeloid leukemia with megakaryoblastic features and p190-type BCR-ABL rearrangement has not previously been reported. The possibility that the combination of a BCR-ABL rearrangement with overexpression of MDR1 may have contributed to the treatment-refractory course is discussed.
Department of Internal Medicine I (Hematology/Oncology), Freiburg University Medical Center, Germany.
H
H
Veelken
T
T
Licht
A
A
Lais
G
G
Köhler
R
R
Mertelsmann
H E
HE
Schaefer
M
M
Lübbert
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000032:analysis; D019008:Drug Resistance, Neoplasm; D005260:Female; D016044:Fusion Proteins, bcr-abl / Q000032:analysis*; D006801:Humans; D007947:Leukemia, Megakaryoblastic, Acute / Q000188:drug therapy / Q000209:etiology / Q000235:genetics* / Q000473:pathology; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000473:pathology; D016609:Neoplasms, Second Primary; D020133:Reverse Transcriptase Polymerase Chain Reaction
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D016044:Fusion Proteins, bcr-abl