演題詳細

ポスター / Poster

ポスター 10 (Poster 10) :CML:臨床 2

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日程
2013年10月11日(金)
時間
16:50 - 17:50
会場
ポスター会場 / Poster (ロイトン札幌 3F ロイトンホールABCD)
座長・司会
増子 正義 (Masayoshi Masuko):1
1:新潟大学医歯学総合病院 高密度無菌治療部
 
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Treatment of a patient with p190 Ph+ CML in lymphoid blast crisis with dasatinib and hyper-CVAD/MA

演題番号 : PS-1-68

早川 梓 (Azusa Hayakawa):1、日高 智徳 (Tomonori Hidaka):2、上運天 綾子 (Ayako Kamiunten):2、関根 雅明 (Masaaki Sekine):2、亀田 拓郎 (Takuro Kameda):2、下田 晴子 (Haruko Shimoda):2、幣 光太郎 (Kotaro Shide):2、久冨木 庸子 (Yoko Kubuki):2、北中 明 (Akira Kitanaka):2、下田 和哉 (Kazuya Shimoda):2

1:Faculty of Medicine, University of Miyazaki, Japan、2:Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, Japan

 

BACKGROUND:In CML, the most common breakpoint in BCR is in the major breakpoint cluster region (M-bcr) that forms an oncogenic fusion protein, namely p210. In very rare cases of CML, breakpoint in the minor breakpoint region (m-bcr) results in a smaller fusion protein p190. At this moment, the treatment outcome in patients with p190 Ph+ blast crisis of CML with tyrosine kinase inhibitor-combined chemotherapy is not yet clarified.
CASE REPORT:We report a case of 35-year-old woman presenting with CML in lymphoid blast crisis who had a m-bcr breakpoint and exhibited myeloproliferative features and an increased number of lymphoblasts in the bone marrow. The presence of m-bcr in the peripheral blood neutrophils was confirmed by FISH. The patient was treated with the combination of dasatinib and hyper-CVAD alternating with high-dose methotrexate and cytarabine (dasatinib-hyper-CVAD/MA). After two courses of therapy, major molecular response was established. According to an extremely poor prognosis without transplantation, after four courses of dasatinib-hyper-CVAD/MA treatment, the patient underwent allogeneic bone marrow transplantation from an HLA-matched unrelated donor.
CONCLUSION:This case indicates that treating patients with p190 Ph+ blast crisis of CML with dasatinib-hyper-CVAD/MA therapy may induce remission period long enough to proceed to allogeneic stem cell transplantation.

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