PMID- 19967494
OWN - NLM
STAT- MEDLINE
DCOM- 20100331
LR  - 20211020
IS  - 1437-7772 (Electronic)
IS  - 1341-9625 (Linking)
VI  - 14
IP  - 6
DP  - 2009 Dec
TI  - Sudden blastic crisis and additional chromosomal abnormalities during chronic 
      myeloid leukemia in the imatinib era.
PG  - 545-50
LID - 10.1007/s10147-009-0884-5 [doi]
AB  - Imatinib has shown significant clinical and cytogenetic success in the treatment 
      of chronic myeloid leukemia. Although resistance has been observed in a 
      proportion of patients, sudden blastic crisis is a rare event during imatinib 
      therapy. We describe a 24-year-old male patient with Philadelphia 
      chromosome-positive chronic myeloid leukemia in chronic phase who developed 
      sudden blastic crisis in the 24th month of imatinib therapy, with loss of 
      complete cytogenetic response. At this time, the patient had splenomegaly, severe 
      anemia, thrombocytopenia, and leukocytosis. Bone marrow aspirate revealed the 
      presence of massive blastic infiltration with myeloid morphology. Flow cytometric 
      analysis of the bone marrow cells showed positivity for CD45, CD34, CD13, CD33, 
      CD19, CD41, CD61, and glycophorin-A. Trephine biopsy specimens showed 100% 
      cellular marrow with diffuse infiltrate by blasts. A reticulin stain of the bone 
      marrow biopsy section demonstrated severe diffuse fibrosis. Cytogenetic analysis 
      by fluorescence in situ hybridization (FISH) revealed that 92% of the cells were 
      positive for the BCR/ABL fusion signal and had increased copy numbers for 
      chromosomes 8, 13, 19, and 21. The patient's prognosis was unfavorable. In 
      conclusion, chronic myeloid leukemia remains complex and includes unanswered 
      questions. The presented case with a rare event during imatinib therapy 
      highlights the need for the continued monitoring of residual disease and the 
      development of strategies to eliminate residual leukemia cells in patients 
      showing a complete cytogenetic response.
FAU - Ali, Ridvan
AU  - Ali R
AD  - Division of Hematology, Department of Internal Medicine, Uludag University School 
      of Medicine Hospital, 16059 Gorukle, Bursa, Turkey. ridvanali@uludag.edu.tr
FAU - Ozkalemkas, Fahir
AU  - Ozkalemkas F
FAU - Ozkocaman, Vildan
AU  - Ozkocaman V
FAU - Yakut, Tahsin
AU  - Yakut T
FAU - Nazlioglu, Hulya Ozturk
AU  - Nazlioglu HO
FAU - Budak, Ferah
AU  - Budak F
FAU - Pekgoz, Murat
AU  - Pekgoz M
FAU - Korkmaz, Serhat
AU  - Korkmaz S
FAU - Karkucak, Mutlu
AU  - Karkucak M
FAU - Ozcelik, Tulay
AU  - Ozcelik T
FAU - Tunali, Ahmet
AU  - Tunali A
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20091205
PL  - Japan
TA  - Int J Clin Oncol
JT  - International journal of clinical oncology
JID - 9616295
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Benzamides)
RN  - 0 (Piperazines)
RN  - 0 (Pyrimidines)
RN  - 8A1O1M485B (Imatinib Mesylate)
SB  - IM
MH  - Adult
MH  - Antineoplastic Agents/*therapeutic use
MH  - Benzamides
MH  - Blast Crisis/*diagnosis/pathology
MH  - *Chromosome Aberrations
MH  - Cytogenetic Analysis
MH  - Humans
MH  - Imatinib Mesylate
MH  - In Situ Hybridization, Fluorescence
MH  - Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis/*drug 
      therapy/*pathology
MH  - Male
MH  - Piperazines/*therapeutic use
MH  - Pyrimidines/*therapeutic use
EDAT- 2009/12/08 06:00
MHDA- 2010/04/01 06:00
CRDT- 2009/12/08 06:00
PHST- 2008/10/20 00:00 [received]
PHST- 2009/02/15 00:00 [accepted]
PHST- 2009/12/08 06:00 [entrez]
PHST- 2009/12/08 06:00 [pubmed]
PHST- 2010/04/01 06:00 [medline]
AID - 10.1007/s10147-009-0884-5 [doi]
PST - ppublish
SO  - Int J Clin Oncol. 2009 Dec;14(6):545-50. doi: 10.1007/s10147-009-0884-5. Epub 
      2009 Dec 5.