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Deep Molecular Response Achieved with Chemotherapy, Dasatinib and Interferon α in Patients with Lymphoid Blast Crisis of Chronic Myeloid Leukaemia

The treatment outcome in patients with chronic myeloid leukaemia (CML) in blast crisis (BC) is unsatisfactory despite the use of allogeneic stem cell transplantation (ASCT). Moreover, in some patients ASCT is contraindicated, with limited treatment options. We report the case series of two patients...

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Autores principales: Vráblová, Lucia, Divoký, Vladimír, Kořalková, Pavla, Poláková, Kateřina Machová, Kriegová, Eva, Janská, Romana, Grohmann, Jan, Holzerová, Milena, Papajík, Tomáš, Faber, Edgar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9916434/
https://www.ncbi.nlm.nih.gov/pubmed/36768374
http://dx.doi.org/10.3390/ijms24032050
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author Vráblová, Lucia
Divoký, Vladimír
Kořalková, Pavla
Poláková, Kateřina Machová
Kriegová, Eva
Janská, Romana
Grohmann, Jan
Holzerová, Milena
Papajík, Tomáš
Faber, Edgar
author_facet Vráblová, Lucia
Divoký, Vladimír
Kořalková, Pavla
Poláková, Kateřina Machová
Kriegová, Eva
Janská, Romana
Grohmann, Jan
Holzerová, Milena
Papajík, Tomáš
Faber, Edgar
author_sort Vráblová, Lucia
collection PubMed
description The treatment outcome in patients with chronic myeloid leukaemia (CML) in blast crisis (BC) is unsatisfactory despite the use of allogeneic stem cell transplantation (ASCT). Moreover, in some patients ASCT is contraindicated, with limited treatment options. We report the case series of two patients with lymphoid BC CML in whom ASCT was not approachable. The first patient developed BC two months after diagnosis in association with dic(7;9)(p11.2;p11.2) and T315I mutation. Blast crisis with central nervous system leukemic involvement and K611N mutation of the SETD2 gene developed abruptly in the second patient five years after ceasing treatment with nilotinib in major molecular response (MMR) at the patient’s request. Both underwent one course of chemotherapy in combination with rituximab and imatinib, followed by dasatinib and interferon α (INFα) treatment in the first and dasatinib alone in the second case. Deep molecular response (DMR; MR 4.0) was achieved within a short time in both cases. It is probable that DMR was caused by a specific immune response to CML cells, described in both agents. The challenging medical condition that prompted these case series, and the subsequent results, suggest a re-visit to the use of a combination of well-known drugs as an area for further investigation.
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spelling pubmed-99164342023-02-11 Deep Molecular Response Achieved with Chemotherapy, Dasatinib and Interferon α in Patients with Lymphoid Blast Crisis of Chronic Myeloid Leukaemia Vráblová, Lucia Divoký, Vladimír Kořalková, Pavla Poláková, Kateřina Machová Kriegová, Eva Janská, Romana Grohmann, Jan Holzerová, Milena Papajík, Tomáš Faber, Edgar Int J Mol Sci Case Report The treatment outcome in patients with chronic myeloid leukaemia (CML) in blast crisis (BC) is unsatisfactory despite the use of allogeneic stem cell transplantation (ASCT). Moreover, in some patients ASCT is contraindicated, with limited treatment options. We report the case series of two patients with lymphoid BC CML in whom ASCT was not approachable. The first patient developed BC two months after diagnosis in association with dic(7;9)(p11.2;p11.2) and T315I mutation. Blast crisis with central nervous system leukemic involvement and K611N mutation of the SETD2 gene developed abruptly in the second patient five years after ceasing treatment with nilotinib in major molecular response (MMR) at the patient’s request. Both underwent one course of chemotherapy in combination with rituximab and imatinib, followed by dasatinib and interferon α (INFα) treatment in the first and dasatinib alone in the second case. Deep molecular response (DMR; MR 4.0) was achieved within a short time in both cases. It is probable that DMR was caused by a specific immune response to CML cells, described in both agents. The challenging medical condition that prompted these case series, and the subsequent results, suggest a re-visit to the use of a combination of well-known drugs as an area for further investigation. MDPI 2023-01-20 /pmc/articles/PMC9916434/ /pubmed/36768374 http://dx.doi.org/10.3390/ijms24032050 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Vráblová, Lucia
Divoký, Vladimír
Kořalková, Pavla
Poláková, Kateřina Machová
Kriegová, Eva
Janská, Romana
Grohmann, Jan
Holzerová, Milena
Papajík, Tomáš
Faber, Edgar
Deep Molecular Response Achieved with Chemotherapy, Dasatinib and Interferon α in Patients with Lymphoid Blast Crisis of Chronic Myeloid Leukaemia
title Deep Molecular Response Achieved with Chemotherapy, Dasatinib and Interferon α in Patients with Lymphoid Blast Crisis of Chronic Myeloid Leukaemia
title_full Deep Molecular Response Achieved with Chemotherapy, Dasatinib and Interferon α in Patients with Lymphoid Blast Crisis of Chronic Myeloid Leukaemia
title_fullStr Deep Molecular Response Achieved with Chemotherapy, Dasatinib and Interferon α in Patients with Lymphoid Blast Crisis of Chronic Myeloid Leukaemia
title_full_unstemmed Deep Molecular Response Achieved with Chemotherapy, Dasatinib and Interferon α in Patients with Lymphoid Blast Crisis of Chronic Myeloid Leukaemia
title_short Deep Molecular Response Achieved with Chemotherapy, Dasatinib and Interferon α in Patients with Lymphoid Blast Crisis of Chronic Myeloid Leukaemia
title_sort deep molecular response achieved with chemotherapy, dasatinib and interferon α in patients with lymphoid blast crisis of chronic myeloid leukaemia
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9916434/
https://www.ncbi.nlm.nih.gov/pubmed/36768374
http://dx.doi.org/10.3390/ijms24032050
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