Monocytic Crisis of Chronic Myeloid Leukemia in the Era of Tyrosine Kinase Inhibitor

Tsunemine, Hiroko; Arima, Hiroshi; Itoh, Kiminari; Sakane-Ishikawa, Emiko; Akasaka, Hiroshi; Kodaka, Takeshi; Takahashi, Takayuki

doi:10.3960/jslrt.53.227

Cited by 6 publications

(5 citation statements)

References 26 publications

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“…In the blast phase, blasts are myeloblasts in 70% of cases and lymphoblasts in 20% to 30% of cases. They are rarely megakaryoblasts, basophilic blasts, monoblasts, or eosinophilic blasts [ 2 , 3 ]. It has been found that patients treated with TKIs are more likely to show unusual blasts (43.5%) than patients who do not undergo TKI treatment (11.4%) [4] .…”

Section: Introductionmentioning

confidence: 99%

A case report and case review: Chronic myeloid leukemia (CML) blast phase with myelomastocytic differentiation

Song

Liu

Pinilla‐Ibarz

et al. 2020

Leukemia Research Reports

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We presented a patient with CML who progressed to unclassical blast phase after Tyrosine Kinase Inhibitors (TKIs) therapy. The patient presented with 2 populations of blasts: one with no cytoplasmic granules and was CD117 weak+/tryptase-/CD34- (typical myeloblasts), and another with metochromatic granules in the cytoplasm and was CD117 strong+/tryptase+/CD25+/CD34 subset+ (myelomastocytic blasts). Almost all the cells were positive for BCR/ABL1 fusion and no KT V816F mutation was detected. The patient was misdiagnosed as having blast phase CML with coexisting mast cell leukemia at an outside institute. Three similar cases and previously described myelomastocytic leukemia are reviewed and discussed.

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Section: Introductionmentioning

confidence: 99%

A case report and case review: Chronic myeloid leukemia (CML) blast phase with myelomastocytic differentiation

Song

Liu

Pinilla‐Ibarz

et al. 2020

Leukemia Research Reports

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“…There have been 13 previous reports of CML blast phase (monocytic lineage) in the English-language literature [3, 4]. However, there are only two reports of CML blast phase (monocytic lineage)in the TKI era.…”

Section: Discussion/conclusionmentioning

confidence: 99%

The First Reported Case of Allogenic Hematopoietic Stem Cell Transplantation for CML Blast Phase (Monocytic Lineage) in the Tyrosine Kinase Inhibitor Era

et al. 2022

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Chronic myeloid leukemia (CML) blast phase (monocytic lineage) is extremely rare. A 39-year-old Japanese man was diagnosed with CML blast phase (monocytic lineage). T315I mutation was positive, ponatinib was initially started, and then, allogenic hematopoietic stem cell transplantation (allo-HSCT) was performed. Seven days after allo-HSCT, hyper-acute graft-versus-host disease developed, and medial temporal lobe encephalitis emerged 24 days after allo-HSCT. He was alive for over 1 year after allo-HSCT. This is the first case report of HSCT for CML blast phase (monocytic lineage) in tyrosine kinase inhibitor era. Further cases should be documented for effective treatment regimen and analysis of clinical features.

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“…The choice of chemotherapy depends on the cellular phenotype of the acute leukemic transformation. The most common phenotype of BC is the myeloid phenotype comprising approximately two-thirds of the cases, followed by the lymphoid, megakaryocytic, erythroid, basophilic, and rarely monocytic and eosinophilic phenotype [5]. The BC with mastocytic differentiation is an absolutely rare entity and only two cases have been reported in the literature around the world [6,7].…”

Section: Discussionmentioning

confidence: 99%

Myelomastocytic Blast Cell Crisis in Resistant Tyrosine Kinase Inhibitor Chronic Myelogenous Leukemia: Case Report and Review of Literature

Martínez-Cordero¹,

Patiño-Escobar²,

Enciso³

et al. 2019

Cureus

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We present the clinical case of a 29-year-old male with a diagnosis of chronic myeloid leukemia (CML) in high-risk chronic phase since February 2010. He started treatment with imatinib at a dose of 400 mg obtaining a hematologic response early but without reaching a cytogenetic response in month 18. Then, dasatinib was prescribed. The BCR-ABL transcription level of 58% was documented. It was decided to start treatment with nilotinib but in March 2017 we diagnosed a progression to blast crisis (BC) of myeloid origin with a bone marrow study that documented 72% of blasts with normal karyotype, also very striking, the concomitant skin infiltration, bone lesions of lytic type and hypercalcemia that required the use of zoledronic acid as an emergency. At the end of chemotherapy induction with 7 + 3 (seven days of cytarabine and three days of idarubicin) chemotherapy associated with bosutinib for 14 days and after several infectious complications, we documented a percentage of blasts by flow cytometry of 29% in the bone marrow and the existence of 46% of cells with basophilic characteristics versus mast cells. A basophilic transformation was suspected versus aggressive systemic mastocytosis with a clonal, nonmastocytic hematological disorder. Levels of serum tryptase and mutation D816V C KIT were requested, which were not possible to perform. Treatment with CLAG-M was proposed, however, the patient died early with hyperleukocytosis and severe thrombocytopenia with central nervous system bleeding.

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Monocytic Crisis of Chronic Myeloid Leukemia in the Era of Tyrosine Kinase Inhibitor

Cited by 6 publications

References 26 publications

A case report and case review: Chronic myeloid leukemia (CML) blast phase with myelomastocytic differentiation

A case report and case review: Chronic myeloid leukemia (CML) blast phase with myelomastocytic differentiation

The First Reported Case of Allogenic Hematopoietic Stem Cell Transplantation for CML Blast Phase (Monocytic Lineage) in the Tyrosine Kinase Inhibitor Era

Myelomastocytic Blast Cell Crisis in Resistant Tyrosine Kinase Inhibitor Chronic Myelogenous Leukemia: Case Report and Review of Literature

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