Sudden extramedullary and extranodal Philadelphia-positive anaplastic large-cell lymphoma transformation during imatinib treatment for CML:A case report  

作　　者：Qiong Wu Yong Kang Jing Xu Wen-Can Ye Zhen-Jiang Li Wen-Feng He Yuan Song Qing-Ming Wang Ai-Ping Tang Ting Zhou 

机构地区：[1]Department of Clinical Laboratory,The Second Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi Province,China [2]Department of Hematology,The Second Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi Province,China [3]Department of Hematology,Pingxiang People's hospital,Pingxiang 337000,Jiangxi Province,China [4]Department of Hematology,The First Affiliated Hospital of Gannan Medical University,Ganzhou 341001,Jiangxi Province,China [5]Key laboratory of Molecular Medicine of Jiangxi,The Second Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi Province,China [6]Department of Pathology,The Second Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi Province,China

出　　处：《World Journal of Clinical Cases》2022年第28期10339-10345,共7页世界临床病例杂志

基　　金：Supported by the Jiangxi“5511”Science and Technology Innovation Talent Project,No.20171BCB18003。

摘　　要：BACKGROUND Chronic myeloid leukemia(CML)is a malignant hematologic malignancy that can progress to blast phase with a myeloid or lymphoid phenotype.Some patients with CML can also progress to blast crisis phase;however,the transformation of CML into Philadelphia-positive lymphoma is extremely rare.CASE SUMMARY We present a patient with CML who experienced a sudden transformation to anaplastic large-cell lymphoma(ALCL)after 7 mo of treatment with imatinib,during which she had achieved partial cytogenetic response as well as early molecular response.The patient noticed a mass in her left shoulder,the biopsy data of which were consistent with ALCL;moreover,her lymphoma cells exhibited BCR-ABL gene fusion.The patient was diagnosed with Philadelphia-positive ALCL that progressed from CML,and was thus treated with the second generation tyrosine kinase inhibitor nilotinib.Six months later,the mass had totally disappeared and the BCR-ABL fusion gene was undetectable in the peripheral blood.To our knowledge,this is the first patient known to have developed Philadelphia-positive ALCL transformed from CML.CONCLUSION Unexplained lymphadenopathy or an extramedullary mass in a patient with CML may warrant a biopsy and testing for BCR-ABL fusion.

关 键 词：Chronic myeloid leukemia BCR-ABL fusion gene Imatinib mesylate Anaplastic large-cell lymphoma Philadelphia-positive NILOTINIB Case report 

分 类 号：R733.72[医药卫生—肿瘤]