[Disease transformation in imatinib mesylate treated Philadelphia chromosome-positive chronic myelogenous leukemia patients achieved cytogenetic remissions].
OBJECTIVE
To report disease transformation in 3 imatinib mesylate treated Philadelphia chromosome-positive chronic myelogenous leukemia (Ph(+)CML) patients who achieved cytogenetic response.


METHODS
Hematologic examinations and bone marrow G-banding karyotyping were evaluated at regular intervals in 3 patients with Ph(+)CML who achieved hematologic responses during continuous imatinib therapy, including 1 patient in first chronic phase (case 1), 1 patient in second chronic phase (case 2) and 1 patient in accelerated phase (case 3).


RESULTS
Case 1, case 2 and case 3 achieved complete cytogenetic response after 4, 3 and 6 months of imatinib therapy respectively. Though under continuously imatinib treatment, they developed acute lymphoblastic leukemia, acute myelogenous leukemia and extramedullary blast crisis in the following 12, 6 and 0 months respectively. Cytogenetic studies of bone marrow in the crisis period showed that cells in case 1 and case 3 had a complete cytogenetic response (Ph(+)cell=0), but case 2 had 20% Ph(+) cells.


CONCLUSIONS
Acute leukemia or extramedullary blast crisis with Ph(-) cells or dominant Ph(-) cells in bone marrow may occur in the patients with Ph(+)CML after imatinib therapy.
Jiang
Qian
Q
Institute of Hematology, Peking University People's Hospital, Beijing 100044, China. jiangqian@medmail.com.cn
Chen
Shan-shan
SS
Jiang
Bin
B
Jiang
Hao
H
Lu
Ying
Y
Lu
Dao-pei
DP
D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001549:Benzamides; D018450:Disease Progression; D005260:Female; D006801:Humans; D000068877:Imatinib Mesylate; D007621:Karyotyping; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000009:adverse effects / Q000627:therapeutic use*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D011743:Pyrimidines / Q000009:adverse effects / Q000627:therapeutic use*; D012074:Remission Induction
D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D011505:Protein-Tyrosine Kinases