Favorable early response of secondary chronic myeloid leukemia to imatinib

Abstract

Second malignant neoplasms are gradually becoming a recognized long-term complication of successful cancer treatment, and they usually respond poorly to conventional therapy and have an unfavorable outcome. Chronic myeloid leukemia (CML) is a clonal panmyelopathy, rarely seen in children with a specific cytogenetic aberration-the Philadelphia chromosome. The translocation generates an aberrant tyrosine kinase, which drives the malignant process in CML and which is also the molecular target for successful treatment of CML with imatinib. It is also exceedingly rare as a secondary malignant neoplasm in both adults and children. We report two cases of secondary CML. The first occurred after successful treatment for nasopharyngeal carcinoma in a child, and the second after treatment for lymphoma in an adolescent. Both patients had an excellent response to treatment with imatinib and attained complete cytogenetic remissions. We conclude that secondary CML may respond favorably to treatment with imatinib.

Chronic Myeloid Leukemia as a Secondary Malignancy after Lymphoma in a Child. A Case Report and Review of the Literature

“…Unfortunately,inourcase,nocytogeneticBMstudywasperformed duringstagingforDLBCL. Imatinibmesylatehasshownefficacyandsafetyasapotent inhibitoroftheconstitutivelyactivatedABLtyrosinekinase whichiscrucialtothepathogenesisofCML [13].According totheliterature,secondaryPh-positiveCMLrespondsfavorablytoimatinibmesylatetherapy [25][26][27].ThesignificantresponsetoimatinibtherapysuggeststhatthemolecularpathogenesisofsecondaryCMLissimilartothatofprimaryCML, andthattheBCR-ABLtranscriptplaysasimilarroleinboth diseases. In accordance with this, the reported cases of secondaryCMLappeartohavethesamecourseandprognosisas de novo CML [7].…”

Chronic myeloid leukemia in acute lymphoblastic leukemia survivor: A case report

“…[1] There have been case reports in literature where survivors of various malignancies develop CML after a latent period. [2,3] The significance of this observation is largely unknown though many patients are exposed to radiation therapy as part of treatment programmes.…”

Bcr‐abl positive blast crisis of chronic myeloid leukemia emerging in a case of metastatic colorectal cancer 3 months after completion of an 8‐month course of cetuximab and irinotecan

“…CML is a rare event as secondary malignant neoplasm (2). However, large epidemiological studies failed to disclose a higher incidence of CML in patients who have previously been treated for a primary cancer (3).…”