Successful treatment with ABL tyrosine kinase inhibitor for patients with acute myeloid leukemia with BCR-ABL1

Abstract

Acute myeloid leukemia (AML) with BCR-ABL1 is rare and has a poor prognosis with conventional chemotherapy or ABL tyrosine kinase inhibitors (TKIs) alone. We reported a case of AML with BCR-ABL1 patient who was successfully treated with dasatinib alone; additionally, we previously reported another case of long-term remission maintained with imatinib monotherapy. These results suggested that a treatment with a novel and significantly potent TKI may be effective in AML with BCR-ABL1 patients with low tumor burden and without additional chromosome aberrations and ABL kinase domain mutations.

AML with BCR-ABL1 Fusion treated with Imatinib, a Hypomethylating Agent and Venetoclax

“…Venetoclax plus TKI (ponatinib or dasatinib) -based regimens with decitabine or intensive chemotherapy showed favorable outcomes and hematologic responses in relapsed/refractory Ph+ AML in a retrospective study in which seven patients were treated [10] , prompting its investigation in an ongoing phase II trial (NCT04188405). TKIs were also reported to provide molecular response in Ph+ AML carrying rare BCR-ABL1 transcripts, such as the e1a3 variant, and few cases of TKI monotherapy have provided durable molecular remissions [ 5 , 11 ].…”

“…Less frequently, atypical BCR-ABL transcripts with e1a2 or e19a2 junctions are identified. The presence of a BCR-ABL1 fusion in de novo acute myeloid leukemia (AML) is rare, with an incidence of 0.5%−3% of newly diagnosed cases [4] , [5] , [6] .…”