HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Chung, H.-J. Articles by Lee, J.-H. Search for Related Content PubMed PubMed Citation Articles by Chung, H.-J. Articles by Lee, J.-H.

Promyelocytic Blast Crisis of Chronic Myeloid Leukemia during Imatinib Treatment

Address correspondence to Hyun-Sook Chi, M.D., Department of Laboratory Medicine, University of Ulsan College of Medicine, 388-1 Pungnap-2dong, Songpa-gu, Seoul 138-736, South Korea; tel 82 2 3010 4502; fax 82 2 478 0884; e-mail hschi{at}amc.seoul.kr.

A 32-yr-old man with the chronic phase of chronic myeloid leukemia (CML-CP) was treated with imatinib mesylate for 6 mo. The real-time quantitative reverse transcription PCR ratio for BCR/ABL in blood mRNA (BCR/ABL RT-QPCR) decreased from an initial value of 0.0159 to a low value of 0.0012 after 3 mo, indicating complete hematologic response. During the next 3 mo, the patient progressed to a promyelocytic blast crisis, displaying leukemic cells containing both BCR/ABL and PML/RAR chimeric mRNAs. Complete remission was achieved by therapy with all-trans retinoic acid (ATRA) and high-dose imatinib mesylate. Using retrospective PML/RAR RT-QPCR with a bone marrow specimen obtained at the initial diagnosis of CML-CP, we quantified the mRNA ratio as 0.000321, suggesting that the clonal evolution of PML/RAR translocation occurred early in the CML-CP.

Keywords: acute promyelocytic leukemia, all-trans retinoic acid, BCR/ABL, PML/RAR, imatinib