Imatinib-based Treatment for Philadelphia Chromosome-positive Acute Lymphoblastic Leukemia Initially Presented as Skeletal Destruction:A Case Report and Literatures Review_West China Medical Journal

Authors：

 ZHANGLi , FENGBo , CHENMeng , KUANGPu ,  PANLing , LIUTing

Department of Hematology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

PANLing, Email: lingpan20002000@aliyun.com

Keywords：

Imatinib; Skeletal destruction; Acute lymphoblastic leukemia

DOI：

10.7507/1002-0179.20140187

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To report and analyze one case of Philadelphia chromosome-positive (Ph⁺) acute lymphoblastic leukemia (ALL) initially presented with skeletal destruction treated with imatinib-based personal therapy. Methods We described the therapeutic advancements for ALL cases initially presented as skeletal destruction and Ph⁺ ALL through case report and literature review. Results Definite diagnosis of Ph⁺ ALL was made for the patient who subsequently obtained inductive remission and 17-month molecular remission with the aid of imatinib-based regimen. Conclusion We should take potential diagnosis of ALL into consideration for patients with skeletal destruction. Imatinib-based standard chemotherapeutic regimen may improve therapeutic model and prognosis of Ph⁺ ALL.

Citation： ZHANGLi, FENGBo, CHENMeng, KUANGPu, PANLing, LIUTing. Imatinib-based Treatment for Philadelphia Chromosome-positive Acute Lymphoblastic Leukemia Initially Presented as Skeletal Destruction:A Case Report and Literatures Review. West China Medical Journal, 2014, 29(4): 620-623. doi: 10.7507/1002-0179.20140187 Copy

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9.	徐燕, 朱燕, 李乃适, 等. 以骨量低下、多发骨破坏为首发临床表现的急性淋巴细胞白血病[J]. 中华骨质疏松和骨矿盐疾病杂志, 2009, 2(4):272-276.
10.	侯凌, 张炼, 林汉华, 等. 以骨质疏松为首发症状的急性白血病一例[J]. 中华儿科杂志,2001, 39(3):22-25.
11.	Fielding AK. Current treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia[J]. Hematology Am Soc Hematol Educ Program, 2010, 95(1):8-12.
12.	Score J, Calasanz MJ, Ottman O, et al. Analysis of genomic breakpoints in p190 and p210 BCR-ABL indicate distinct mechanisms of formation[J]. Leukemia, 2010, 24(10):1742-1750.
13.	Mizuta S, Matsuo K, Maeda T, et al. Prognostic factors influencing clinical outcome of allogeneic hematopoietic stem cell transplantation following imatinib-based therapy in BCR-ABL-positive ALL[J]. Blood Cancer J, 2012, 2(5):e72.
14.	Ohno R. Changing paradigm of the treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia[J]. Curr Hematol Malig Rep, 2010, 5(4):213-221.
15.	Mizuta S, Matsuo K, Yagasaki F, et al. Pre-transplant imatinib-base therapy improves the outcome of allogeneic hematopoietic stem cell transplantation for BCR-ABL-positive acute lymphoblastic leukemia[J]. Leukemia, 2011, 25(1):41-47.
16.	刘霆. Ph阳性急性淋巴细胞白血病的治疗进展与思考[J]. 中华血液学杂志, 2012, 33(2):73-75.
17.	Dimou M, Panayiotidis P. Tyrosine kinase inhibitors and interferon[J]. Mediterr J Hematol Infect Dis, 2014, 6(1):e2014006.
18.	Larson RA, Druker BJ, Guilhot F, et al. Imatinib pharmacokinetics and its correlation with response and safety in chronic-phase chronic myeloid leukemia:a subanalysis of the IRIS study[J]. Blood, 2008, 111(8):4022-4028.

1. Pui CH, Mullighan CG, Evans WE, et al. Pediatric acute lymphoblastic leukemia:where are we going and how do we get there?[J]. Blood, 2012, 120(6):1165-1174.
2. American Cancer Society. Cancer Facts and Figures 2014[R]. Atlanta, Ga:American Cancer Society, 2014.
3. Swerdlow SH, Campo E, Harris NL, et al. WHO classification of tumors of hea matopoietic and lymphoid tissues[M]. 4 ed. Lyon:LARC Press, 2008:168-178.
4. Shahnazi M, Khatami A, Shamsian B, et al. Bony lesions in pediatric acute leukemia:pictorial essay[J]. Iran J Radiol, 2012, 9(1):50-56.
5. Bertuna G, Famà P, Lo Nigro L, et al. Marked osteoporosis and spontaneous vertebral fractures in children:don't forget, it could be leukemia[J]. Med Pediatr Oncol, 2003, 41(5):450-451.
6. Atas A, Cakmak A, Soran M, et al. Severe osteoporosis and high level TSH in a child before the diagnosis of acute lymphoblastic leukemia[J]. Pediatr Hematol Oncol, 2009, 31(8):588-591.
7. Hafiz MG, Islam A. Extensive skeletal lesions in childhood acute lymphoblastic leukemia[J]. Mymensingh Med J, 2009, 18(1):88-94.
8. Hafiz MG, Islam A, Siddique R. Back pain and vertebral compression:an unusu al presentation of childhood acute lymphoblastic leukemia[J]. Mymensingh Med J, 2010, 19(1):130-136.
9. 徐燕, 朱燕, 李乃适, 等. 以骨量低下、多发骨破坏为首发临床表现的急性淋巴细胞白血病[J]. 中华骨质疏松和骨矿盐疾病杂志, 2009, 2(4):272-276.
10. 侯凌, 张炼, 林汉华, 等. 以骨质疏松为首发症状的急性白血病一例[J]. 中华儿科杂志,2001, 39(3):22-25.
11. Fielding AK. Current treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia[J]. Hematology Am Soc Hematol Educ Program, 2010, 95(1):8-12.
12. Score J, Calasanz MJ, Ottman O, et al. Analysis of genomic breakpoints in p190 and p210 BCR-ABL indicate distinct mechanisms of formation[J]. Leukemia, 2010, 24(10):1742-1750.
13. Mizuta S, Matsuo K, Maeda T, et al. Prognostic factors influencing clinical outcome of allogeneic hematopoietic stem cell transplantation following imatinib-based therapy in BCR-ABL-positive ALL[J]. Blood Cancer J, 2012, 2(5):e72.
14. Ohno R. Changing paradigm of the treatment of Philadelphia chromosome-positive acute lymphoblastic leukemia[J]. Curr Hematol Malig Rep, 2010, 5(4):213-221.
15. Mizuta S, Matsuo K, Yagasaki F, et al. Pre-transplant imatinib-base therapy improves the outcome of allogeneic hematopoietic stem cell transplantation for BCR-ABL-positive acute lymphoblastic leukemia[J]. Leukemia, 2011, 25(1):41-47.
16. 刘霆. Ph阳性急性淋巴细胞白血病的治疗进展与思考[J]. 中华血液学杂志, 2012, 33(2):73-75.
17. Dimou M, Panayiotidis P. Tyrosine kinase inhibitors and interferon[J]. Mediterr J Hematol Infect Dis, 2014, 6(1):e2014006.
18. Larson RA, Druker BJ, Guilhot F, et al. Imatinib pharmacokinetics and its correlation with response and safety in chronic-phase chronic myeloid leukemia:a subanalysis of the IRIS study[J]. Blood, 2008, 111(8):4022-4028.

West China Medical Journal

Imatinib-based Treatment for Philadelphia Chromosome-positive Acute Lymphoblastic Leukemia Initially Presented as Skeletal Destruction:A Case Report and Literatures Review

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