Isolated central nervous system relapse in two patients with BCR-ABL-positive acute leukemia while receiving a next-generation tyrosine kinase inhibitor.
We describe two patients with break point cluster region-Abelsen (BCR-ABL)-positive acute leukemia who had an isolated relapse in the central nervous system (CNS) while receiving a next-generation BCR-ABL inhibitor. The first had B-cell acute lymphoblastic leukemia which relapsed in the CNS while maintaining molecular remission in the bone marrow on nilotinib. The second patient had an isolated CNS myeloid blast crisis of chronic myeloid leukemia while maintaining complete cytogenetic remission in the bone marrow on dasatinib. Mutation analysis of the kinase domain revealed 35 base pair insertion (35INT) between exon 8 and 9 in both cases.
Department of Internal Medicine, Texas Tech University, Paul L. Foster School of Medicine, El Paso, TX, U.S.A. sumit.gaur@ttuhsc.edu.
Sumit
S
Gaur
Department of Pathology, Texas Tech University, Paul L. Foster School of Medicine, El Paso, TX, U.S.A.
Ali-Reza
AR
Torabi
Department of Internal Medicine, Texas Tech University, Paul L. Foster School of Medicine, El Paso, TX, U.S.A.
Javier
J
Corral
D000328:Adult; D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001853:Bone Marrow / Q000473:pathology; D001921:Brain / Q000473:pathology; D016543:Central Nervous System Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000556:secondary*; D002555:Cerebrospinal Fluid / Q000166:cytology; D003131:Combined Modality Therapy; D016044:Fusion Proteins, bcr-abl / Q000235:genetics*; D015870:Gene Expression; D006801:Humans; D007938:Leukemia / Q000175:diagnosis / Q000235:genetics* / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009154:Mutation; D047428:Protein Kinase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011505:Protein-Tyrosine Kinases; D016044:Fusion Proteins, bcr-abl
BCR-ABL-positive leukemia; central nervous system relapse; tyrosine kinase inhibitor