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A Case of Childhood Blastic Phase Chronic Myeloid Leukemia With Minor BCR-ABL

Yamanaka, Junko MD*; Shimizu, Mariko MD; Sato, Maho MD; Inoue, Masami MD; Matsui, Motohiro MD; Shimada, Hiroyuki MD§; Shichino, Hiroyuki MD*

Journal of Pediatric Hematology/Oncology: April 15, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/MPH.0000000000001488
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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: jyamanak@hosp.ncgm.go.jp).

Received December 12, 2018

Accepted March 5, 2019

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