Durable remission in a patient of mixed phenotype acute leukemia with Philadelphia chromosome-positive treated with nilotinib and lenalidomide: A case report.

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

Medicine

authors

Lai B,Mu Q,Zhu H,Wang Y,Zhang Y,Xu K,Sheng L,Ouyang G

doi

10.1097/MD.0000000000010294

subject

Has Abstract

pub_date

2018-04-01 00:00:00

pages

e0294

issue

14

eissn

0025-7974

issn

1536-5964

pii

00005792-201804060-00028

journal_volume

97

pub_type

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