Early blastic transformation following complete cytogenetic response in a pediatric chronic myeloid leukemia patient treated with imatinib mesylate.
This article reports early blastic transformation of chronic myeloid leukemia (CML) in a child following a complete cytogenetic response induced by imatinib mesylate. A 14-year-old Japanese boy was diagnosed with t(9;22) cryptic CML in the chronic phase and treated with imatinib. His response to treatment was slow, but a major cytogenetic response was obtained at 142 days of therapy. However, he developed lymphoid blastic transformation at 9 months. He attained remission with acute lymphoblastic leukemia-type chemotherapy and then successfully received a non-T-cell-depleted allogeneic stem cell transplantation (allo-SCT) with his mother's two loci-mismatched donor cells. A sudden blastic transformation may occur even with a complete cytogenetic response induced by imatinib. CML patients who respond slowly to imatinib may still be candidates for allo-SCT, even when a major cytogenetic response is obtained.
Morimoto
Akira
A
Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan. akiramorimoto@hotmail.com
Ogami
Aya
A
Chiyonobu
Tomohiro
T
Takanashi
Mami
M
Sugimoto
Tohru
T
Imamura
Toshihiko
T
Ishida
Hiroyuki
H
Yoshihara
Takao
T
Imashuku
Shinsaku
S
D000293:Adolescent; D001549:Benzamides; D001752:Blast Crisis / Q000209:etiology / Q000628:therapy*; D020732:Cytogenetic Analysis; D018572:Disease-Free Survival; D018380:Hematopoietic Stem Cell Transplantation; D006648:Histocompatibility; D006801:Humans; D000068877:Imatinib Mesylate; D015466:Leukemia, Myeloid, Chronic-Phase / Q000188:drug therapy* / Q000628:therapy; D008213:Lymphocyte Activation; D008297:Male; D010879:Piperazines / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D012008:Recurrence; D012074:Remission Induction / Q000379:methods; D014184:Transplantation, Homologous
D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate