Abstract
T-cell acute lymphoblastic leukemia (T-ALL) is a rare entity in the adult acute leukemia setting. Translocation (9;22)(q34;q11) and BCR-ABL1 rearrangement are occasionally found in T-ALL and have been reported in no more than 100 cases in the literature (most of which are chronic myeloid leukemia blast crisis). Here, we report the remarkable effectiveness of third-generation tyrosine-kinase inhibitor ponatinib in obtaining hematological and metabolic remission, in a patient with Philadelphia chromosome-positive de novo T-ALL and outcomes of a therapeutic strategy containing chemotherapy intensification, nelarabine, and allogeneic hematopoietic stem cell transplantation.
References
1.
Martinelli
G
, Piciocchi
A
, Papayannidis
C
, Paolini
S
, Robustelli
V
, Soverini
S
, First report of the gimema LAL1811 phase II prospective study of the combination of steroids with ponatinib as frontline therapy of elderly or unfit patients with Philadelphia chromosome-positive acute lymphoblastic leukemia
. Blood
. 2017
;130
(Suppl 1
):99
. .2.
Jabbour
E
, Short
NJ
, Ravandi
F
, Huang
X
, Daver
N
, DiNardo
CD
, Combination of hyper-CVAD with ponatinib as first-line therapy for patients with Philadelphia chromosome-positive acute lymphoblastic leukemia: long-term follow-up of a single-centre, phase 2 study
. Lancet Haematol
. 2018
;5
:e618
–27
.3.
Saini
L
, Brandwein
J
. New treatment strategies for Philadelphia chromosome-positive acute lymphoblastic leukemia
. Curr Hematol Malig Rep
. 2017
;12
:136
–42
. .4.
Dunsmore
KP
, Devidas
M
, Linda
SB
, Borowitz
MJ
, Winick
N
, Hunger
SP
, Pilot study of nelarabine in combination with intensive chemotherapy in high-risk T-cell acute lymphoblastic leukemia: a report from the Children’s Oncology Group
. J Clin Oncol
. 2012
;30
(22
):2753
–9
.5.
Verrma
SP
, Dutta
TK
, Vinod
KV
, Dubashi
B
, Ariga
KK
. Philadelphia chromosome positive pre-T cell acute lymphoblastic leukemia: a rare case report and short review
. Indian J Hematol Blood Transfus
. 2014 Sep
;30
(Suppl 1
):177
–9
. .6.
Jain
P
, Kantarjian
H
, Jabbour
E
, Kanagal-Shamanna
R
, Patel
K
, Pierce
S
, Clinical characteristics of Philadelphia positive T-cell lymphoid leukemias: (de novo and blast phase CML)
. Am J Hematol
. 2017 Jan
;92
(1
):E3
–4
.7.
Paul
S
, Kantarjian
H
, Jabbour
EJ
. Adult acute lymphoblastic leukemia
. Mayo Clin Proc
. 2016
;91
(11
):1645
–66
. .8.
Ragg
S
, Zehentner
BK
, Loken
MR
, Croop
JM
. Evidence for BCR/ABL1-positive T-cell acute lymphoblastic leukemia arising in an early lymphoid progenitor cell
. Pediatr Blood Cancer
. 2019
;66
:e27829
. .9.
Tchirkov
A
, Bons
JM
, Chassagne
J
, Schoepfer
C
, Kanold
J
, Briançon
G
, Molecular detection of a late-appearing BCR-ABL gene in a child with T-cell acute lymphoblastic leukemia
. Ann Hematol
. 1998
;77
:55
–9
. .10.
Lalayanni
C
, Baldoumi
E
, Papayiannopoulos
S
, Tziola
K
, Saloum
R
, Anagnostopoulos
A
. Nelarabine-associated reversible Guillain-Barré-like syndrome or myelopathy in an adult patient with primary refractory T-lymphoblastic lymphoma
. Curr Probl Cancer
. 2017 Mar–Apr
;41
(2
):138
–43
. .11.
Raanani
P
, Trakhtenbrot
L
, Rechavi
G
, Rosenthal
E
, Avigdor
A
, Brok-Simoni
F
, Philadelphia-chromosome-positive T-lymphoblastic leukemia: acute leukemia or chronic myelogenous leukemia blastic crisis
. Acta Haematol
. 2005
;113
(3
):181
–9
. .© 2021 S. Karger AG, Basel
2021
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