Reactions 1324 - 23 Oct 2010

SAntineoplastics

Chronic myelomonocytic leukaemia treated withimatinib: case report

A man developed chronic myelomonocytic leukaemiafollowing treatment with multiple antineoplastics for acutepromyelocytic leukaemia (APL). He was successfullytreated with imatinib mesylate.

Diagnosed in August 1999, the 58-year-old manachieved complete remission following tretinoin,cytarabine and idarubicin therapy [treatment details notstated]; however, he developed APL differentiationsyndrome. Consolidation and intensive maintenancechemotherapy was administered until October 2001,which consisted of idarubicin, mitoxantrone, daunorubicin,aclarubicin and etoposide at cumulative doses of 60, 31,270, 56 and 980 mg/m2, respectively [routes and frequencyof administration not stated]. After 6.5 years of continuousremission, his leucocyte count gradually increased fromApril 2006. A blood count in May 2007 showed ahaemoglobin level of 14.6 g/dL, platelet count of182 × 109/L, leucocyte count of 15.9 × 109/L, with 4%promyelocytes, 3% metamyelocytes, 62% neutrophils, 9%eosinophils and 8% monocytes. Bone marrow aspirationrevealed myeloid cell hyperplasia (76.8%), 1.2% blasts and3.2% eosinophils, and a karyotype of46,XY,t(5,12)(q33;p13)[17]/46,XY[3]. RT-PCR analysis ofthe marrow and peripheral blood yielded the TEL(ETV6)-PDGFRB fusion gene, leading to a diagnosis of therapy-related chronic myelomonocytic leukaemia with t(5;12).

No treatments were administered until the man’shaemoglobin and platelet count decreased. InOctober 2008, his leucocyte count increased further to16.5 × 109/L but his platelet count and haemoglobin levelsdropped slightly. He received oral imatinib, and within2 weeks, his leucocyte count normalised. Bone marrowaspiration showed a normal karytoype and normaldifferentiation, and the fusion gene was not detected. Hehas remained in remission after 18 months of imatinibtherapy with no adverse effects.Asou N, et al. Successful treatment with low-dose imatinib mesylate of therapy-related myeloid neoplasm harboring TEL-PDGFRB in a patient with acutepromyelocytic leukemia. Haematologica 95: E1-E2, No. 9, Sep 2010. Availablefrom: URL: http://dx.doi.org/10.3324/haematol.2010.27656 - Japan 803042577

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Reactions 23 Oct 2010 No. 13240114-9954/10/1324-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved