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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A case of CML achieving to a molecular remission in nilotinib after allogeneic transplantation

演題番号 : PS-1-69

伊藤 俊朗 (Toshiro Ito):1、酒井 香生子 (Kaoko Sakai):1、酒井 均 (Hitoshi Sakai):1、妹尾 紀子 (Noriko Senoo):1、仁科 さやか (Sayaka Nishina):1、関口 和 (Nodoka Sekiguchi):1,3、石田 文宏 (Fumihiro Ishida):1,2

1:Division of Hematology, Int. Med., Shinshu Univ., Japan、2:Dept. Biomedical Laboratory Sciences, Shinshu Univ., Japan、3:Dept. Comprehensive Cancer Therapy, Shinshu Univ., Japan

 

The case is fifty four age woman. She was introduced by our hospital, becouse her WBC count was 128,000/μL. She had a diagnosis of B acute lymphoblastic leukemia (B-ALL), becouse >90% of nucleated cells of bone marrow were myeloperoxidase-negative and CD10, CD19-possitive blasts. Her treatment was started in JALSG ALL-202 protocol. Major BCR-ABL mRNA increasd by the multiplex PCR test at this time, but Minor BCR-ABL mRNA was not detected. In addition the Philadelphia chromosome (Ph) was possitve, she had a diagnosis of Ph+ALL. Her treatment was changed to Ph+ protocol to use imatinib together and achieved a hematological complete remission. She had a diagnosis of chronic myelogenous leukemia (CML), becouse neutorphilic FISH of peripheral blood were possitve after induction therapy. Her initial presentation in blastic phase CML without a previously detectable chronic phase (CP). She proceeded bone marrow transplantation from daughter who has one locus mismatched HLA at second CP with cytogenetic remission, but without molecular remission. Even if six months passed from transplantation, she did not achieve to molecular remission. So immunosuppressant were discontinued and she was given 800mg/day of nilotinib. She achieved a complete molecular remission (CMR) by nested revers trascriptase-PCR three months latter after nilotinib started. She maitains CMR for two years after she starts nilotinib. There are few reports of the experience of nilotinib after transplantation. This case suggested that nilotinib was effective for a molecular failure after traslpantation for the CML.

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