Successful treatment with allogeneic stem cell transplantation followed by DLI and TKIs for e6a2 BCR-ABL -positive acute myeloid leukaemia: A case report and literature review

Yasuhiko Harada, Satoshi Nishiwaki, Takumi Sugimoto, Koichi Onodera, Tatsunori Goto, Takahiko Sato, Sonoko Kamoshita, Naomi Kawashima, Aika Seto, Shingo Okuno, Satomi Yamamoto, Toshihiro Iwasaki, Yukiyasu Ozawa, Koichi Miyamura, Yoshiki Akatsuka, Isamu Sugiura

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Rationale:Patients with the e6a2 BCR-ABL transcript, 1 of the atypical transcripts, have been reported to have a poor prognosis, and allogeneic stem cell transplantation (ASCT) can be considered as additional therapy. However, long-term survival after ASCT for this disease is rare.Patient concerns:This report concerns a 55-year-old female patient with e6a2 BCR-ABL-positive acute myeloid leukemia including the outcome of ASCT followed by donor lymphocyte infusion (DLI).Diagnoses:The breakpoint was confirmed by direct sequencing. Her minimal residual disease could be detected by nested reverse-transcription polymerase chain reaction using primers for the minor BCR-ABL (e1a2) transcript.Interventions:Treatment with tyrosine kinase inhibitors (TKIs) and ASCT followed by DLI.Outcomes:Despite multiple cytogenetic and molecular relapses after ASCT, she remains in molecular remission at 46 months after ASCT.Lessons:This case indicates the efficacy of the combination of the graft-versus-leukemia effect and TKIs for e6a2 BCR-ABL-positive acute leukemia. When the Philadelphia chromosome with an unusual chromosomal breakpoint is suggested, we should clarify the breakpoint because that information can aid molecular assessments and decisions to provide an additional or alternative therapy.

Original languageEnglish
Article numbere9160
JournalMedicine (United States)
Volume96
Issue number50
DOIs
Publication statusPublished - 01-12-2017

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Stem Cell Transplantation
Acute Myeloid Leukemia
Protein-Tyrosine Kinases
Tissue Donors
Lymphocytes
Leukemia
Therapeutics
Philadelphia Chromosome
Residual Neoplasm
Complementary Therapies
Rare Diseases
Cytogenetics
Reverse Transcription
Transplants
Recurrence
Polymerase Chain Reaction
Survival

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Harada, Yasuhiko ; Nishiwaki, Satoshi ; Sugimoto, Takumi ; Onodera, Koichi ; Goto, Tatsunori ; Sato, Takahiko ; Kamoshita, Sonoko ; Kawashima, Naomi ; Seto, Aika ; Okuno, Shingo ; Yamamoto, Satomi ; Iwasaki, Toshihiro ; Ozawa, Yukiyasu ; Miyamura, Koichi ; Akatsuka, Yoshiki ; Sugiura, Isamu. / Successful treatment with allogeneic stem cell transplantation followed by DLI and TKIs for e6a2 BCR-ABL -positive acute myeloid leukaemia : A case report and literature review. In: Medicine (United States). 2017 ; Vol. 96, No. 50.
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abstract = "Rationale:Patients with the e6a2 BCR-ABL transcript, 1 of the atypical transcripts, have been reported to have a poor prognosis, and allogeneic stem cell transplantation (ASCT) can be considered as additional therapy. However, long-term survival after ASCT for this disease is rare.Patient concerns:This report concerns a 55-year-old female patient with e6a2 BCR-ABL-positive acute myeloid leukemia including the outcome of ASCT followed by donor lymphocyte infusion (DLI).Diagnoses:The breakpoint was confirmed by direct sequencing. Her minimal residual disease could be detected by nested reverse-transcription polymerase chain reaction using primers for the minor BCR-ABL (e1a2) transcript.Interventions:Treatment with tyrosine kinase inhibitors (TKIs) and ASCT followed by DLI.Outcomes:Despite multiple cytogenetic and molecular relapses after ASCT, she remains in molecular remission at 46 months after ASCT.Lessons:This case indicates the efficacy of the combination of the graft-versus-leukemia effect and TKIs for e6a2 BCR-ABL-positive acute leukemia. When the Philadelphia chromosome with an unusual chromosomal breakpoint is suggested, we should clarify the breakpoint because that information can aid molecular assessments and decisions to provide an additional or alternative therapy.",
author = "Yasuhiko Harada and Satoshi Nishiwaki and Takumi Sugimoto and Koichi Onodera and Tatsunori Goto and Takahiko Sato and Sonoko Kamoshita and Naomi Kawashima and Aika Seto and Shingo Okuno and Satomi Yamamoto and Toshihiro Iwasaki and Yukiyasu Ozawa and Koichi Miyamura and Yoshiki Akatsuka and Isamu Sugiura",
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Harada, Y, Nishiwaki, S, Sugimoto, T, Onodera, K, Goto, T, Sato, T, Kamoshita, S, Kawashima, N, Seto, A, Okuno, S, Yamamoto, S, Iwasaki, T, Ozawa, Y, Miyamura, K, Akatsuka, Y & Sugiura, I 2017, 'Successful treatment with allogeneic stem cell transplantation followed by DLI and TKIs for e6a2 BCR-ABL -positive acute myeloid leukaemia: A case report and literature review', Medicine (United States), vol. 96, no. 50, e9160. https://doi.org/10.1097/MD.0000000000009160

Successful treatment with allogeneic stem cell transplantation followed by DLI and TKIs for e6a2 BCR-ABL -positive acute myeloid leukaemia : A case report and literature review. / Harada, Yasuhiko; Nishiwaki, Satoshi; Sugimoto, Takumi; Onodera, Koichi; Goto, Tatsunori; Sato, Takahiko; Kamoshita, Sonoko; Kawashima, Naomi; Seto, Aika; Okuno, Shingo; Yamamoto, Satomi; Iwasaki, Toshihiro; Ozawa, Yukiyasu; Miyamura, Koichi; Akatsuka, Yoshiki; Sugiura, Isamu.

In: Medicine (United States), Vol. 96, No. 50, e9160, 01.12.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Successful treatment with allogeneic stem cell transplantation followed by DLI and TKIs for e6a2 BCR-ABL -positive acute myeloid leukaemia

T2 - A case report and literature review

AU - Harada, Yasuhiko

AU - Nishiwaki, Satoshi

AU - Sugimoto, Takumi

AU - Onodera, Koichi

AU - Goto, Tatsunori

AU - Sato, Takahiko

AU - Kamoshita, Sonoko

AU - Kawashima, Naomi

AU - Seto, Aika

AU - Okuno, Shingo

AU - Yamamoto, Satomi

AU - Iwasaki, Toshihiro

AU - Ozawa, Yukiyasu

AU - Miyamura, Koichi

AU - Akatsuka, Yoshiki

AU - Sugiura, Isamu

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Rationale:Patients with the e6a2 BCR-ABL transcript, 1 of the atypical transcripts, have been reported to have a poor prognosis, and allogeneic stem cell transplantation (ASCT) can be considered as additional therapy. However, long-term survival after ASCT for this disease is rare.Patient concerns:This report concerns a 55-year-old female patient with e6a2 BCR-ABL-positive acute myeloid leukemia including the outcome of ASCT followed by donor lymphocyte infusion (DLI).Diagnoses:The breakpoint was confirmed by direct sequencing. Her minimal residual disease could be detected by nested reverse-transcription polymerase chain reaction using primers for the minor BCR-ABL (e1a2) transcript.Interventions:Treatment with tyrosine kinase inhibitors (TKIs) and ASCT followed by DLI.Outcomes:Despite multiple cytogenetic and molecular relapses after ASCT, she remains in molecular remission at 46 months after ASCT.Lessons:This case indicates the efficacy of the combination of the graft-versus-leukemia effect and TKIs for e6a2 BCR-ABL-positive acute leukemia. When the Philadelphia chromosome with an unusual chromosomal breakpoint is suggested, we should clarify the breakpoint because that information can aid molecular assessments and decisions to provide an additional or alternative therapy.

AB - Rationale:Patients with the e6a2 BCR-ABL transcript, 1 of the atypical transcripts, have been reported to have a poor prognosis, and allogeneic stem cell transplantation (ASCT) can be considered as additional therapy. However, long-term survival after ASCT for this disease is rare.Patient concerns:This report concerns a 55-year-old female patient with e6a2 BCR-ABL-positive acute myeloid leukemia including the outcome of ASCT followed by donor lymphocyte infusion (DLI).Diagnoses:The breakpoint was confirmed by direct sequencing. Her minimal residual disease could be detected by nested reverse-transcription polymerase chain reaction using primers for the minor BCR-ABL (e1a2) transcript.Interventions:Treatment with tyrosine kinase inhibitors (TKIs) and ASCT followed by DLI.Outcomes:Despite multiple cytogenetic and molecular relapses after ASCT, she remains in molecular remission at 46 months after ASCT.Lessons:This case indicates the efficacy of the combination of the graft-versus-leukemia effect and TKIs for e6a2 BCR-ABL-positive acute leukemia. When the Philadelphia chromosome with an unusual chromosomal breakpoint is suggested, we should clarify the breakpoint because that information can aid molecular assessments and decisions to provide an additional or alternative therapy.

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