Co-occurrence of chronic myeloid leukemia with chronic lymphocytic leukemia: a report of two cases

Boddu, Prajwal; Gibbons, Jamie; Burger, Jan A.; Sivina, Mariela; Thakral, Beenu; Kanagal‐Shamanna, Rashmi; Ferrajoli, Alessandra

doi:10.1080/10428194.2018.1547902

Cited by 8 publications

(4 citation statements)

References 18 publications

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“…[40][41][42][43][44] Targeted therapies have also been used successfully in a few cases, strengthening the argument that combination therapies can be safely and effectively administered in these rare patients. 45,46 The most compelling component of this case report is that it highlights the safety and efficacy of concomitant venetoclax and imatinib. Both are well-established therapies in their respective diseases; however, concurrent CML and CLL are exceptionally rare.…”

Section: Discussionmentioning

confidence: 96%

Concomitant Venetoclax and Imatinib for Comanaging Chronic Lymphocytic Leukemia and Chronic Myeloid Leukemia: A Case Report

Przespolewski

Baron

Kashef

et al. 2023

Journal of the National Comprehensive Cancer Network

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Patients with synchronous malignancies can be problematic to diagnose and manage because workup and therapeutic targeting for each individual malignancy must be coordinated carefully. This report presents a patient with concurrent chronic myeloid leukemia (CML) and chronic lymphocytic leukemia (CLL) managed with concomitant venetoclax and imatinib. Because imatinib is a moderate cytochrome P450 3A4 inhibitor, close monitoring is required when using with a substrate of 3A4 such as venetoclax. Although the target dose of venetoclax is 400 mg, it was capped at 100 mg due to the interaction. Despite the interaction and possible enhancement of toxicities, the patient has tolerated therapy well, and both diseases have responded to this novel approach. In addition, because aberrant BCL-2 activity has been implicated in CML, the use of venetoclax may contribute to success in the management of this patient’s CML. This case report represents the safe concomitant use of venetoclax and imatinib in a patient with synchronous CML and CLL.

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Section: Discussionmentioning

confidence: 96%

Concomitant Venetoclax and Imatinib for Comanaging Chronic Lymphocytic Leukemia and Chronic Myeloid Leukemia: A Case Report

Przespolewski

Baron

Kashef

et al. 2023

Journal of the National Comprehensive Cancer Network

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“…CML in CLL coexistence is primarily classified into three imatinib (a TKI) inhibits CYP3A4 metabolism, potentially increasing the levels of ibrutinib (a BTK inhibitor) and predisposing the patient to adverse effects from the BTK inhibitor. Clinicians should carefully weigh the risks and benefits of administering both medications simultaneously [13] .…”

Section: Discussionmentioning

confidence: 99%

A rare case of an elderly male with progression to chronic myeloid leukaemia secondary to chronic lymphocytic leukaemia

Saowapa,

Pangkanon,

Adu

et al. 2024

European Journal of Case Reports in Internal Medicine

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Chronic lymphocytic leukaemia (CLL) is a lymphoproliferative disorder characterised by an accumulation of monoclonal B lymphocytes, with an increased risk of secondary cancers. The coexistence of CLL and chronic myeloid leukaemia (CML) is a rare phenomenon, with three main types being classified: CML preceding CLL, CLL preceding CML and simultaneous occurrence. The coexistence of these chronic leukaemias poses a complex clinical challenge, with the underlying mechanisms of their association remaining enigmatic. Here, we present a report of an elderly male with a long history of CLL, who was subsequently diagnosed with secondary CML.

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“…Rarely the opposite situation or simultaneous occurrence of CLL and CML was reported. Until date, there is no consensus on the treatment approach for these patients (38). Typically, if CLL was in remission the treatment targeted against CML was introduced.…”

Section: Discussionmentioning

confidence: 99%

In vivo, ex vivo and in vitro dasatinib activity in chronic lymphocytic leukemia

et al. 2021

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Dasatinib inhibits the breakpoint cluster region-Abelson murine leukemia 1 ( BCR-ABL1 ) gene along with other kinases known to be overexpressed and abnormally active in patients with chronic lymphocytic leukemia (CLL). The current study used primary leukemic cells obtained from 53 patients with CLL that were treated with dasatinib. A 2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide (XTT) assay and Annexin V staining was performed to assess the cytotoxic effects of dasatinib treatment. The XTT assay revealed that the median cytotoxicity of dasatinib was 8.30% (range, 0.00–77.89%). Due to high dispersion of dasatinib activity, patients were divided into sensitive (n=27; 50.94%; median cytotoxicity, 22.81%) and resistant groups (n=26; 49.06%; median cytotoxicity, 0.00%). A median cytotoxicity of 8.30% was selected as a cut off value. Using Annexin V staining and flow cytometry on exemplary sensitive and resistant CLL samples, it was revealed that 17.71 and 1.84% of cells were apoptotic, respectively. The current study presented a case of a patient with concomitant occurrence of CLL and chronic myeloid leukemia (CML) with a major molecular response after dasatinib treatment. A simultaneous reduction of circulating CLL cells indicated in vivo anti-CLL activity induced by dasatinib. After an in vitro culture of the patient's mononuclear cells with subsequent dasatinib treatment, a higher percentage of CLL cells undergoing apoptosis was obsevered when compared with untreated samples (38.19 vs. 21.99%, respectively). Similarly, the percentage of CLL apoptotic cells (ΔΨm low ) measured by chloromethyl-X-rosamine was higher after incubation with dasatinib (7.28%) than in the negative control (2.86%). In conclusion, dasatinib induced antileukemic effects against CML and CLL cells. The results of the current study indicated that dasatinib may induce apoptosis ex vivo, in vitro and in vivo in CLL.

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Co-occurrence of chronic myeloid leukemia with chronic lymphocytic leukemia: a report of two cases

Cited by 8 publications

References 18 publications

Concomitant Venetoclax and Imatinib for Comanaging Chronic Lymphocytic Leukemia and Chronic Myeloid Leukemia: A Case Report

Concomitant Venetoclax and Imatinib for Comanaging Chronic Lymphocytic Leukemia and Chronic Myeloid Leukemia: A Case Report

A rare case of an elderly male with progression to chronic myeloid leukaemia secondary to chronic lymphocytic leukaemia

In vivo, ex vivo and in vitro dasatinib activity in chronic lymphocytic leukemia

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