Extramedullary blast crisis in a patient with chronic myelogenous leukemia in complete cytogenetic and molecular remission on interferon-alpha therapy.

Abstract

We report the previously undescribed occurrence of extramedullary blast crisis in a patient with chronic myelogenous leukemia in complete cytogenetic and molecular remission on interferon-alpha. Development of bilateral testicular swelling prompted a biopsy showing stromal infiltration with CD20 and TdT positive immature cells. On repeated examinations, the bone marrow remained BCR/ABL negative by RT-PCR analysis. However, the cerebrospinal fluid (CSF) contained atypical lymphocytes positive for the P210 BCR-ABL product. Following treatment with testicular irradiation, intrathecal methotrexate, systemic chemotherapy and an unrelated donor transplant, the patient showed no evidence of disease until 9 months post-transplant, when he relapsed in lymphoid blast crisis in both bone marrow and CSF.

• Authors: A Beedassy, D Topolsky, M Styler, P Crilley
• Journal: Leukemia research (Leuk Res) Vol. 24 Issue 8 Pg. 733-5 (Aug 2000) ISSN: 0145-2126 [Print] England
• PMID: 10936425 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antineoplastic Agents
• Interferon-alpha
• Fusion Proteins, bcr-abl

Topics

• Adult
• Antineoplastic Agents (therapeutic use)
• Blast Crisis
• Fusion Proteins, bcr-abl (genetics)
• Genes, abl
• Humans
• Interferon-alpha (therapeutic use)
• Leukemia, Myelogenous, Chronic, BCR-ABL Positive (drug therapy, genetics, pathology)
• Male
• Remission Induction