Abstract:
RATIONALE:Philadelphia chromosome-positive mixed phenotype acute leukemia (Ph+ MPAL) is a rare type of leukemia with poor prognosis. Tyrosine kinase inhibitors (TKIs) in combination with chemotherapy have significantly improved its remission rate. However, relapse remains the major obstacle to achieve long survival. Lenalidomide is a second-generation oral immunomodulatory drug that has been broadly applied in the treatment of various hematological malignancies. PATIENT CONCERNS:A 54-year-old Chinese male patient who complained of chest pain and fatigue for 20 days. Bone marrow aspirate examination revealed hypercellularity with 70% blast cells. Flow cytometry analysis revealed that the blast cells exhibit both myeloid and lymphoid lineage antigens. Chromosomal analysis reveals t(9;22)(q34;q11) translocation. Minor BCR-ABL fusion gene was positive. DIAGNOSIS:Philadelphia chromosome-positive mixed phenotype acute leukemia. INTERVENTIONS:After relapsed from routine chemotherapy plus imatinib, the therapy was switched to oral therapy with nilotinib and lenalidomide due to his feeble condition. OUTCOMES:He successfully achieved long survival after oral therapy with nilotinib and lenalidomide. LESSONS:Combination of TKIs with lenalidomide may be an effective maintenance treatment regimen for Ph+ MPAL patients with minimal side effect.
journal_name
Medicine (Baltimore)journal_title
Medicineauthors
Lai B,Mu Q,Zhu H,Wang Y,Zhang Y,Xu K,Sheng L,Ouyang Gdoi
10.1097/MD.0000000000010294subject
Has Abstractpub_date
2018-04-01 00:00:00pages
e0294issue
14eissn
0025-7974issn
1536-5964pii
00005792-201804060-00028journal_volume
97pub_type
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