Acute myeloid leukemia with t(11;19)(q23;p13.1) in a patient with a gastrointestinal stromal tumor undergoing imatinib therapy:A case report  

作　　者：Hong Jun Kim Sun Kyung Baek Chi Hoon Maeng Si-Young Kim Tae Sung Park Jae Joon Han 

机构地区：[1]Department of Hematology and Medical Oncology,Kyung Hee University,Seoul 02447,South Korea [2]Department of Laboratory Medicine,Kyung Hee University,Seoul 02447,South Korea

出　　处：《World Journal of Clinical Cases》2020年第7期1251-1256,共6页世界临床病例杂志

摘　　要：BACKGROUND Acute myeloid leukemia(AML)harboring 11q23 translocations is classified as therapy-related AML in patients who have undergone prior treatment with cytotoxic agents.There have been only a few reports of AML that subsequently developed during imatinib mesylate(IM)treatment for gastrointestinal stromal tumors(GISTs).CASE SUMMARY A 63-year-old woman was diagnosed with a hepatic GIST recurrence in April 2012;she was administered IM 400 mg/d.In November 2015,she developed dyspnea with pancytopenia while IM treatment was continued for 42 mo.A chromosome study using a bone marrow sample showed a 46,XX karyotype with t(11;19)(q23;p13.1)in 22 of 26 analyzed metaphase cells.Fluorescence in situ hybridization using the locus-specific indicator(11q23)gene break-apart probe showed positive rearrangement in 82%of interphase cells.Reverse-transcription polymerase chain reactions subsequently confirmed the KMT2A/ELL transcript.She achieved complete response with incomplete neutrophil recovery with two decitabine treatment cycles.After the third cycle of decitabine,the disease relapsed,and she refused further treatment.She died of hemorrhagic stroke 5 mo after diagnosis.To the best of our knowledge,this is the first report of AML with KMT2A gene rearrangements in a patient with a GIST receiving IM treatment.CONCLUSION Physicians should consider the potential risks of developing hematologic malignancies,including therapy-related AML,in patients with GISTs receiving IM treatment.

关 键 词：Acute MYELOID leukemia Gastrointestinal STROMAL tumor IMATINIB KMT2A MYELODYSPLASTIC syndrome Case report 

分 类 号：R733.71[医药卫生—肿瘤] R735[医药卫生—临床医学]