Chronic Myeloid Leukemia Relapsing 25 Years after Allogenic Stem Cell Transplantation
Reikvam, Håkon; Skavland, Jørn; Gullaksen, Stein-Erik; Hovland, Randi; Gedde-Dahl, Tobias; Bruserud, Øystein; Gjertsen, Bjørn Tore
Peer reviewed, Journal article
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Date
2018-09-23Metadata
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https://doi.org/10.1155/2018/2045985Abstract
Chronic myeloid leukemia (CML) is a myeloproliferative disorder in which neoplastic cells exhibit the Philadelphia chromosome and the related oncoprotein BCR-ABL1. Allogeneic stem cell transplantation (allo-SCT) was considered the first-line treatment for CML, before the introduction of tyrosine kinase inhibitors (TKIs). However, patients are at risk for relapse years after transplantation. We present a patient who relapsed 25 years after allo-SCT for chronic phase CML. Polymerase chain reaction (PCR) detected gradually evaluated levels of BCR-ABL1 transcripts, eventually leading to the diagnosis of relapsed disease. Additional mutational analyses did not reveal mutations in the BCR-ABL1 gene, or other cooperating mutations. The patient was successfully treated with imatinib 400 mg daily, leading to new molecular remission. The case presentation emphasizes the need for long-term follow-up of such patients and the potential benefit of initiating TKI treatment with early signs of relapse.