title: Coexistence of independent myelodysplastic and Philadelphia chromosome positive clones in a patient treated with hydroxyurea.
abstract: We report a patient with Philadelphia chromosome positive (Ph +ve) chronic myelogenous leukemia (CML), treated with hydroxyurea alone, who upon disease progression developed an additional Ph - ve clone containing chromosomal abnormalities typical of myelodysplastic syndrome (MDS). Retrospective analysis of a cryopreserved stem cell specimen from diagnosis confirmed that this second clone developed during the course of treatment. The development of a clone with additional cytogenetic abnormalities in CML has only been reported after leukemogenic treatment, stem cell transplantation or interferon. We report a case of secondary Ph - ve MDS/AML during blast crisis in a patient treated with hydroxyurea for CML.
authors.affiliation: Department of Medicine, Columbia University College of Physicians and Surgeons, Herbert Irving Comprehensive Cancer Center, 650 W, 168th Street BB-20-08, New York, NY, 10032, USA. mjf3@columbia.edu
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Flamm
authors.forename: V V V S
authors.initials: VV
authors.lastname: Murty
authors.forename: Pulivarthi H
authors.initials: PH
authors.lastname: Rao
authors.forename: Gwen L
authors.initials: GL
authors.lastname: Nichols
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001752:Blast Crisis / Q000235:genetics* / Q000473:pathology; D002454:Cell Differentiation; D002908:Chronic Disease; D005260:Female; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use*; D007621:Karyotyping; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy / Q000235:genetics / Q000473:pathology; D009190:Myelodysplastic Syndromes / Q000235:genetics* / Q000473:pathology*; D016609:Neoplasms, Second Primary; D010677:Philadelphia Chromosome
chemical_list: D000970:Antineoplastic Agents; D006918:Hydroxyurea