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BCR-ABL1 acute myeloid leukemia: clonal selection of a BCR-ABL1(-) subclone as a cause of refractory disease with nilotinib treatment

Item Type:Article
Title:BCR-ABL1 acute myeloid leukemia: clonal selection of a BCR-ABL1(-) subclone as a cause of refractory disease with nilotinib treatment
Creators Name:Neuendorff, N.R. and Schwarz, M. and Hemmati, P. and Tuerkmen, S. and Bommer, C. and Burmeister, T. and Doerken, B. and le Coutre, P. and Arnold, R. and Westermann, J.
Abstract:The presence of a Philadelphia chromosome with a corresponding BCR-ABL1 rearrangement is the hallmark of chronic myeloid leukemia, but is considered a very rare event in de novo acute myeloid leukemia (AML). Here, we report the first case in which a dominant Philadelphia chromosome-positive subclone was detected upon relapse in a formerly Philadelphia chromosome-negative MLL-AF6(+) AML. Due to refractory disease under salvage chemotherapy, the patient was started on nilotinib treatment. As a result, the Philadelphia chromosome-positive subclone was eradicated within 1 month; however, disease progressed and was again dominated by the Philadelphia chromosome-negative founding clone, demonstrating rapid clonal expansion under nilotinib-induced selection pressure.
Keywords:Acute Myeloid Leukemia, Philadelphia Chromosome, Nilotinib
Source:Acta Haematologica
ISSN:0001-5792
Publisher:Karger (Switzerland)
Volume:133
Number:2
Page Range:237-241
Date:2015
Official Publication:https://doi.org/10.1159/000368176
PubMed:View item in PubMed

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