title: Imatinib-based therapy in adult Philadelphia chromosome-positive acute lymphoblastic leukemia: A case report and literature review.
abstract: Acute lymphoblastic leukemia (ALL) has a rapid onset and rarely occurs with exclusive prodrome of general osteoporosis and vertebral compression fractures. However, Philadelphia chromosome-positive (Ph+) ALL has a poor prognosis, even when patients are treated with intensive chemotherapy, and the first-line effective treatment requires further elucidation. The present study focused on a 56-year-old Chinese male patient who initially presented with spontaneous bone fractures and was ultimately diagnosed as Ph+ALL after 6 months, which required to preliminarily exclude a working diagnosis of myeloma. Apart from intensive chemotherapy, the patient successfully completed an imatinib-based regimen and achieved complete remission (CR) 2 weeks later. Subsequently, the patient was subjected to consolidation treatment using the same imatinib regimen combined with interferon-α 2b for 9 courses. In November 2013, the patient had achieved persistent hematological and molecular genetic normality for ~16 months after the initial CR. In conclusion, Ph+ALL must be considered in the differential diagnosis of adults experiencing unexplained bone disease.
authors.affiliation: Department of Hematology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.
authors.forename: L I
authors.initials: LI
authors.lastname: Zhang
authors.affiliation: Department of Hematology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.
authors.forename: Meng
authors.initials: M
authors.lastname: Chen
authors.affiliation: Department of Hematology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.
authors.forename: B O
authors.initials: BO
authors.lastname: Feng
authors.affiliation: Department of Hematology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.
authors.forename: P U
authors.initials: PU
authors.lastname: Kuang
authors.affiliation: Third Division of Internal Medicine, District People's Hospital, Qionglai Medical Center Hospital, Qionglai, Sichuan 611530, P.R. China.
authors.forename: Peng
authors.initials: P
authors.lastname: He
authors.affiliation: Department of Hematology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.
authors.forename: Ting
authors.initials: T
authors.lastname: Liu
authors.affiliation: Department of Hematology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.
authors.forename: Ling
authors.initials: L
authors.lastname: Pan
keywords: acute lymphoblastic leukemia; fracture; imatinib; osteoporosis