HSCT for Myelid neoplasms with PDGFRβ rearrangement after treatment with TKIs
演題番号 : PS-1-37
原崎 頼子 （Yoriko Harazaki):1、井根 省二 （Syouji Ine):1、遠宮 靖男 （Yasuo Tohmiya):1、佐々木 治 （Osamu Sasaki):1
1:Department of Hematology, Miyagi Cancer Center, Natori, Japan
Myeloid neoplasms with PDGFRβ rearrangement is rare disease. Imatinib was reported be effective, but there have been few reports on dasatinib administration to imatinib-resistant patients. We report a patient of myeloid neoplasms with PDGFRβ rearrangement who received allogeneic bone marrow transplantation (allogeneic BMT) after treatment with imatinib and dasatinib. A 28-year-old female admitted our hospital in March 2004 for an increase in white blood cells detected on health check-up. Chromosomal analysis revealed 46,XX,t(5;14)(q33;q13.2). She was followed with suspected myeloproliferative disorders. She admitted our hospital with fever and general malaise in September 2011. Laboratory evaluation revealed WBC count 50.2×103/μl, red cell count 322×104, Hb level 10.3g/dl and platelet count 10.4×103/μl. A bone marrow smear contained 92.6% myeloblasts. FISH analysis showed 97% of marrow cells had PDGFRβ rearrangement. Diagnosis of Myeloid neoplasms with PDGFRβ rearrangement was made. Treatment with imatinib 400mg daily was started. A day27 FISH analysis showed 84% of marrow cells had PDGFRβ rearrangement. The drug was switched to dasatinib 50mg twice daily. Two weeks after dasatinib was started, CR was achieved. In April 2012, bone marrow smear showed 56% blasts, induction therapy with DNR and AraC was started. Allogeneic BMT from her HLA-matched brother was performed on July 5, 2012. Currently CR is being maintained. Dasatinib may be effective for Myeloid neoplasms with PDGFRβ rearrangement.