Korean J Hematol.  2009 Mar;44(1):62-66. 10.5045/kjh.2009.44.1.62.

Complete Hematologic Response and Cytogenetic Remission after Imatinib and Dexamethasone Treatment of a Ph+ Precursor B-cell Acute Lymphoblastic Leukemia in Renal Transplantation Patient

• Baek SK
• Cho KS
• Yang BH
• Kim SY
• Yoon HJ
• Jeong K
• Ihm CG

• KMID: 2252177
• DOI: http://doi.org/10.5045/kjh.2009.44.1.62

Abstract

In this report, we present a case of a patient with Philadelphia chromosome-positive (Ph+) B-cell acute lymphoblastic leukemia after renal transplantation. The patient, a 65-year-old man, had received a kidney transplantation 20 years prior to diagnosis with Ph+ precursor B-cell ALL. Because he was refractory to intensive chemotherapy and had refused to receive additional intensive chemotherapy, he was treated with imatinib and dexamethasone. While this patient experienced a complete hematologic and cytogenetic response, he did not show a complete molecular remission. Eighty days after imatinib combination therapy, the patient relapsed and died from intracerebral hemorrhage.

Keyword

Renal transplantation; Philadelphia chromosome; Acute lymphoblastic leukemia; Imatinib

MeSH Terms

Aged
B-Lymphocytes
Benzamides
Cerebral Hemorrhage
Cytogenetics
Dexamethasone
Humans
Kidney Transplantation
Philadelphia
Philadelphia Chromosome
Piperazines
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Precursor Cells, B-Lymphoid
Pyrimidines
Imatinib Mesylate
Benzamides
Dexamethasone
Piperazines
Pyrimidines

Figure

• 

  Fig. 1. A bone marrow aspiration examination. (A) Wright-Giemsa stain, 200×, there is a diffuse lymphoblast infiltration. It has monotonous small and round nucleus, (B) 1,000×, blast shows scanty and bluish cytoplasm.

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  Fig. 2. BCR/ABL gene rearrangement by fluorescence in situ hybridization (FISH). Nucleus containing t(9:22) has a native ABL (red arrow), a native BCL (green arrow) and two fusion signal (white arrow). This finding show minor breakpoint signal.

Reference

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