Abstract

Imatinib failure and response to dasatinib in a patient with chronic myeloid leukemia in blast crisis and a novel, nine-nucleotide BCR-ABL insertion mutation

Highlights

  • In chronic phase chronic myeloid leukemia (CML), the BCR-ABL kinase inhibitor imatinib leads to complete cytogenetic responses in the majority of cases

  • We report on a patient with CML in blast crisis after imatinib failure and second-line treatment with dasatinib harboring a so far undescribed p.K294S_insFPQ mutation (g.68009_68010ins GTTTCCCTC)

  • On day 131, BCR-ABL/ABL ratio decreased to 13.8% and to 0.9% by day 173 under dasatinib treatment, indicating molecular response

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Summary

Introduction

In chronic phase chronic myeloid leukemia (CML), the BCR-ABL kinase inhibitor imatinib leads to complete cytogenetic responses in the majority of cases. We report on a patient with CML in blast crisis after imatinib failure and second-line treatment with dasatinib harboring a so far undescribed p.K294S_insFPQ mutation (g.68009_68010ins GTTTCCCTC). The BCR-ABL/ABL ratio only decreased to 139.6 and 48.2% on day 50 and 89, respectively, with persistence of 10–15% bone marrow blasts and 17% blasts in the peripheral blood, indicating failure of treatment.

Results
Conclusion

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