Related Experiment Videos
[Acute lymphoblastic leukemia with p190 type bcr/abl chimeric mRNA at relapse]
Ilseung Choi1, Takamitsu Matsushima, Tomomi Fujii
1Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
[Rinsho Ketsueki] the Japanese Journal of Clinical Hematology
|November 5, 2002
Summary
This case study highlights a rare instance of Philadelphia chromosome-positive acute lymphoblastic leukemia, where the Philadelphia chromosome emerged late in the disease. This suggests the bcr/abl fusion gene may also drive disease progression, not just initial development.
Area of Science:
- Hematology
- Oncology
- Molecular Biology
Background:
- Acute lymphoblastic leukemia (ALL) is a heterogeneous hematologic malignancy.
- The Philadelphia chromosome (Ph) is a hallmark of certain ALL subtypes, associated with poor prognosis.
- The role of the bcr/abl fusion gene in leukemogenesis is well-established.
Observation:
- A 23-year-old male with ALL presented with a high leukocyte count and specific immunophenotype (CD10, 19, 20, 33, 34, HLA-DR).
- Initial diagnosis showed no Philadelphia chromosome or p190-type bcr/abl mRNA transcripts.
- Relapse occurred despite induction therapy and allogeneic stem cell transplantation.
Findings:
- The Philadelphia chromosome was detected late in the disease course (day 256).
- p190-type bcr/abl mRNA transcripts became positive from the first relapse onwards.
- Disease progression and relapse occurred despite treatment, with eventual patient mortality.
Implications:
- This case suggests the bcr/abl fusion gene product may be involved in the progression of ALL, not solely its initiation.
- Late detection of the Philadelphia chromosome in ALL warrants further investigation into its role in treatment resistance and relapse.
- Understanding the dynamic role of bcr/abl may inform future therapeutic strategies for refractory ALL.