Chronic myeloid leukemia (CML) is commonly associated with major BCR-ABL transcript. We present a child with blastic phase CML associated with minor BCR-ABL transcript without prior CML diagnosis. Diagnosis was achieved by fluorescence in situ hybridization of peripheral blood neutrophils, which identified 90% as BCR-ABL positive. The patient received chemotherapy with imatinib followed by dasatinib and underwent reduced-intensity hematopoietic allogeneic stem cell transplantation with prophylactic posttransplant dasatinib for 2 years and has remained in complete molecular remission. Our intensified treatment regimen was effective compared with previous studies on minor BCR-ABL CML describing inferior outcomes with tyrosine kinase inhibitor therapy.
*Department of Pediatrics, National Center for Global Health and Medicine
‡Department of Pediatric Hematology/Oncology, Tokyo Metropolitan Children’s Medical Center
§Department of Pediatrics, Keio University School of Medicine, Tokyo
†Department of Hematology/Oncology, Osaka Women’s and Children’s Hospital, Osaka, Japan
The authors declare no conflict of interest.
Reprints: Junko Yamanaka, MD, Department of Pediatrics, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162 8655, Japan (e-mail: email@example.com).
Received December 12, 2018
Accepted March 5, 2019