演題詳細

ポスター / Poster

ポスター 14 (Poster 14) :MPN:臨床 1

print

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
藤 重夫 (Shigeo Fuji):1
1:国立がん研究センター中央病院 移植科
 
前へ戻る

Philadelphia chromosome positive clone has emerged during 13 years of treatment of polycythemia vera

演題番号 : PS-1-102

滝沢 牧子 (Makiko Takizawa):1、横濱 章彦 (Akihiko Yokohama):2、関上 智美 (Tomomi Sekigami):2、小磯 博美 (Hiromi Koiso):3、石崎 卓馬 (Takuma Ishizaki):1、三井 健揮 (Takeki Mitsui):1、斉藤 貴之 (Takayuki Saitoh):4、半田 寛 (Hiroshi Handa):1、塚本 憲史 (Norifumi Tsukamoto):3、村上 博和 (Hirokazu Murakami):4、野島 美久 (Yoshihisa Nojima):1

1:Department of Medicine and Clinical Science, Gunma Univ., Gunma, Japan、2:Blood Transfusion Service, Gunma Univ., Gunma, Japan、3:Oncology Center, Gunma Univ., Gunma, Japan、4:School of Health Sciences, Faculty of Medicine, Gunma University

 

Myeloproliferative neoplasms (MPNs) are clonal disorders of hematopoietic stem cells and are generally separated from Philadelphia chromosome positive (Ph+) chronic myeloid leukemia (CML). However, several isolated cases with JAK2V617F mutation concomitant with BCR-ABL rearrangement have been reported in the literature. Here we report a case of polycythemia vera (PV) patient exhibited Ph+ CML like clinical feature after 13 years of chronic course and successfully treated with thyrosine kinase inhibitor. She had typical laboratory findings and the bone marrow cells were negative for BCR-ABL translocation by FISH analysis at the time of initial diagnosis in 1998, treated with hydroxycarbamide and low dose aspirin. Because of the progressive leukocytosis and immature neutrophil emergence in the peripheral blood, chromosome analysis was performed. Ph chromosome was positive in 18 cells out of 20 cells analyzed. At this time point, JAK2V617F mutation was undetectable but when we looked back, the mutation was positive at the peripheral blood sample in 2008. She responded well to a treatment with 100 mg of dasatinib and harboring JAK2 mutation again. This is a rare case with emerging CML like clone negative for JAK2 mutation and re-exhibited JAK2 mutation after a reduction of the Ph clone with TKI. This case gives us an insight of a clonal divergence and growth advantage of Ph clone in MPNs. We will also discuss about the past reports on this matter.

前へ戻る