title: [Successful treatment with dasatinib for polycythemia vera patient emerging BCR-ABL positive clone during 13 years of treatment].
abstract: Herein, we report a patient with polycythemia vera (PV) who exhibited Philadelphia chromosome (Ph) positive CML-like clinical features after 13 years of hydroxycarbamide administration and successful treatment with a tyrosine kinase inhibitor (TKI). She was 64 years old when initially diagnosed with PV and was confirmed to be negative for BCR-ABL translocation. Thirteen years later, with increasing white blood cell and platelet counts, a BCR-ABL positive clone emerged and the JAK2V617F mutation disappeared. After TKI treatment, the BCR-ABL copy number decreased and the JAK2V617F mutation was again detected. Furthermore, MPN clinical features were observed. This case provides insights into the clonal divergence and growth advantage of the Ph positive clone over the MPN clone. Whether JAK2V617F is an MPN initiating event or a secondary mutation has been a point of discussion for the past several years. This issue is also considered in the present report.
authors: Department of Medicine and Clinical Science, Graduate School of Medicine, Gunma University.
authors: Makiko
authors: M
authors: Takizawa
authors: Akihiko
authors: A
authors: Yokohama
authors: Tomomi
authors: T
authors: Sekigami
authors: Hiromi
authors: H
authors: Koiso
authors: Takuma
authors: T
authors: Ishizaki
authors: Takeki
authors: T
authors: Mitsui
authors: Yoshiyuki
authors: Y
authors: Ogawa
authors: Takayuki
authors: T
authors: Saitoh
authors: Hiroshi
authors: H
authors: Handa
authors: Norifumi
authors: N
authors: Tsukamoto
authors: Hirokazu
authors: H
authors: Murakami
authors: Yoshihisa
authors: Y
authors: Nojima
mesh_terms: D000069439:Dasatinib; D005260:Female; D016044:Fusion Proteins, bcr-abl / Q000235:genetics; D006801:Humans; D053614:Janus Kinase 2 / Q000235:genetics; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications / Q000188:drug therapy* / Q000235:genetics; D008875:Middle Aged; D009154:Mutation; D011087:Polycythemia Vera / Q000150:complications / Q000188:drug therapy* / Q000235:genetics; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D013844:Thiazoles / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D047428:Protein Kinase Inhibitors; D011743:Pyrimidines; D013844:Thiazoles; D016044:Fusion Proteins, bcr-abl; D053614:Janus Kinase 2; D000069439:Dasatinib