Early blastic transformation following complete cytogenetic response in a pediatric chronic myeloid leukemia patient treated with imatinib mesylate

• Published in: Journal of pediatric hematology/oncology Vol. 26; no. 5; p. 320
• Main Authors: Morimoto, Akira, Ogami, Aya, Chiyonobu, Tomohiro, Takanashi, Mami, Sugimoto, Tohru, Imamura, Toshihiko, Ishida, Hiroyuki, Yoshihara, Takao, Imashuku, Shinsaku
• Format: Journal Article
• Language: English
• Published: United States 01.05.2004
• Subjects: Adolescent; Benzamides; Blast Crisis - etiology; Blast Crisis - therapy; Cytogenetic Analysis; Disease-Free Survival; Hematopoietic Stem Cell Transplantation; Histocompatibility; Humans; Imatinib Mesylate; Leukemia, Myeloid, Chronic-Phase - drug therapy; Leukemia, Myeloid, Chronic-Phase - therapy; Lymphocyte Activation; Male; Piperazines - therapeutic use; Pyrimidines - therapeutic use; Recurrence; Remission Induction - methods; Transplantation, Homologous
• ISSN: 1077-4114
• DOI: 10.1097/00043426-200405000-00013

This article reports early blastic transformation of chronic myeloid leukemia (CML) in a child following a complete cytogenetic response induced by imatinib mesylate. A 14-year-old Japanese boy was diagnosed with t(9;22) cryptic CML in the chronic phase and treated with imatinib. His response to treatment was slow, but a major cytogenetic response was obtained at 142 days of therapy. However, he developed lymphoid blastic transformation at 9 months. He attained remission with acute lymphoblastic leukemia-type chemotherapy and then successfully received a non-T-cell-depleted allogeneic stem cell transplantation (allo-SCT) with his mother's two loci-mismatched donor cells. A sudden blastic transformation may occur even with a complete cytogenetic response induced by imatinib. CML patients who respond slowly to imatinib may still be candidates for allo-SCT, even when a major cytogenetic response is obtained.