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Successful cord blood transplantation in a minor BCR-ABL+ CML patient who had been in lymphoid blast crisis at presentation

Bone Marrow Transplantation volume 37, pages 535–536 (2006)Cite this article

Most CML patients have major bcr-abl (M-bcr) transcripts but a small minority possessing exclusively a minor bcr-abl (m-bcr) transcript has been described.1, 2 Only five of the 1384 CML patients (0.36%) in the extensive study by Ravandi et al.3 were m-bcr+. So far, 23 cases of CML with m-bcr transcripts have been reported in the literature. Among these, there are only three case reports of blast crisis (BC) at presentation. A GVL effect may contribute to the long-term remission of M-bcr CML patients after allogeneic stem cell transplantation (allo-SCT).4 However, whether a GVL effect can also be contrived in m-bcr+ CML remains unclear. Here, we describe a patient with m-bcr+ CML, who was diagnosed as having had lymphoid BC of m-bcr+ CML at presentation, and underwent cord blood transplantation (CBT), resulting in long-term molecular remission. This is the first report of successful CBT for m-bcr+ CML.

A 36-year-old woman was admitted in September 2000 with skin purpuras, anemia and fever. She had no hepato-splenomegaly. Peripheral blood examination showed WBC 25.7 × 109/l with 72% blasts and 1% monocytes, Hb 8.3 g/dl and platelets 9 × 109/l. BM examination at that time revealed that 99.0% of cells were peroxidase-negative leukemic blasts. These cells were positive for CD10, CD19, CD20, CD34, and HLA-DR. Chromosome analysis revealed Philadelphia chromosome (Ph) positivity in 14/20 analyzed metaphase cells. However, M-bcr transcripts were not present (by RT-PCR), but m-bcr were. From these findings, the patient was initially diagnosed as Ph-positive ALL (FAB L2).

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References

  1. Nakamura H, Inokuchi K, Hanawa H, Yamaguchi H, Tamura H, Tajika K et al. A case of chronic myeloid leukemia with minor bcr-abl transcript following fluorouracil therapy for esophageal carcinoma. Ann Hematol 2000; 79: 396–401.

    Article  CAS  Google Scholar 

  2. Ohno T, Hada S, Sugiyama T, Mizumoto T, Furukawa H, Nagai K . Chronic myeloid leukemia with minor-bcr breakpoint developed hybrid type of blast crisis. Am J Hematol 1998; 57: 320–325.

    Article  CAS  Google Scholar 

  3. Ravandi F, Cortes J, Albitar M, Arlinghaus R, Qiang Guo J, Talpaz M et al. Chronic myelogenous leukaemia with p185(BCR/ABL) expression: characteristics and clinical significance. Br J Haematol 1999; 107: 581–586.

    Article  CAS  Google Scholar 

  4. Guglielmi C, Arcese W, Dazzi F, Brand R, Bunjes D, Verdonck LF et al. Donor lymphocyte infusion for relapsed chronic myelogenous leukemia: prognostic relevance of the initial cell dose. Blood 2002; 100: 397–405.

    Article  CAS  Google Scholar 

  5. Hur M, Song EY, Kang SH, Shin DH, Kim JY, Park SS et al. Lymphoid preponderance and the absence of basophilia and splenomegaly are frequent in m-bcr-positive chronic myelogenous leukemia. Ann Hematol 2002; 81: 219–223.

    Article  CAS  Google Scholar 

  6. Melo JV, Myint H, Galton DA, Goldman JM . P190BCR-ABL chronic myeloid leukaemia: the missing link with chronic myelomonocytic leukaemia? Leukemia 1994; 8: 208–211.

    CAS  PubMed  Google Scholar 

  7. Costello RT, Gabert J, Brunel V, Sainty D, Arnoulet C, Mozziconacci MJ et al. Minor breakpoint cluster region (m-BCR) positive chronic myeloid leukaemia with an acute lymphoblastic leukaemia onset: a case report. Br J Haematol 1995; 91: 428–430.

    Article  CAS  Google Scholar 

  8. Hur M, Lee DS, Cho HI, Jung S, Park S . Lymphoid blast crisis is a natural course of minor breakpoint cluster region–positive chronic myelogenous leukemia. Lab Hematol 2001; 7: 65–67.

    Google Scholar 

  9. Lemes A, Gomez Casares MT, de la Iglesia S, Matutes E, Molero MT . p190 BCR-ABL rearrangement in chronic myeloid leukemia and acute lymphoblastic leukemia. Cancer Genet Cytogenet 1999; 113: 100–102.

    Article  CAS  Google Scholar 

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  1. Division of Hematology, Department of Clinical Cell Biology, Chiba University Graduate School of Medicine, Inohana, Chuo-ku, Chiba City, Chiba, Japan

    C Nakaseko, E Sakaida, T Uehara, K Shono, C Ohwada, S Ozawa, M Takeuchi, R Cho, Y Saito & M Nishimura

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  1. C Nakaseko
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  2. E Sakaida
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Correspondence to C Nakaseko.

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Nakaseko, C., Sakaida, E., Uehara, T. et al. Successful cord blood transplantation in a minor BCR-ABL+ CML patient who had been in lymphoid blast crisis at presentation. Bone Marrow Transplant 37, 535–536 (2006). https://doi.org/10.1038/sj.bmt.1705270

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