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Ann. Clin. Lab. Sci. · Jan 2008
Case ReportsPromyelocytic blast crisis of chronic myeloid leukemia during imatinib treatment.
- Hee-Jung Chung, Hyun-Sook Chi, Young-Uk Cho, Chan-Jeoung Park, Eul Ju Seo, Kyung-Hee Kim, and Je-Hwan Lee.
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, South Korea.
- Ann. Clin. Lab. Sci. 2008 Jan 1; 38 (3): 283-6.
AbstractA 32-yr-old man with the chronic phase of chronic myeloid leukemia (CML-CP) was treated with imatinib mesylate for 6 mo. The real-time quantitative reverse transcription PCR ratio for BCR/ABL in blood mRNA (BCR/ABL RT-QPCR) decreased from an initial value of 0.0159 to a low value of 0.0012 after 3 mo, indicating complete hematologic response. During the next 3 mo, the patient progressed to a promyelocytic blast crisis, displaying leukemic cells containing both BCR/ABL and PML/RARalpha chimeric mRNAs. Complete remission was achieved by therapy with all-trans retinoic acid (ATRA) and high-dose imatinib mesylate. Using retrospective PML/RARalpha RT-QPCR with a bone marrow specimen obtained at the initial diagnosis of CML-CP, we quantified the mRNA ratio as 0.000321, suggesting that the clonal evolution of PML/RARalpha translocation occurred early in the CML-CP.
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