Concurrent acute myeloid leukemia and T lymphoblastic lymphoma in a patient with rearranged PDGFRB genes
Chang, Hung ; Chuang, Wen-Yu ; Sun, Chien-Feng ; Barnard, Marc R.
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UMass Chan Affiliations
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Keywords
Antineoplastic Combined Chemotherapy Protocols
Combined Modality Therapy
Cytarabine
Daunorubicin
Fatal Outcome
Graft vs Host Disease
Humans
Leukemia, Myeloid, Acute
Male
Neoplasms, Multiple Primary
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Receptor, Platelet-Derived Growth Factor beta
Stem Cell Transplantation
Life Sciences
Medicine and Health Sciences
Pathology
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Abstract
Concurrent hematologic malignancies are relatively rare. We encountered a case of concurrent acute myeloid leukemia (AML) and T lymphoblastic lymphoma. The bone marrow chromosome analysis showed the karyotype 46, XY, t(5;12)(q33;p13), which indicated presence of PDGFRB gene translocations. Therefore, this disease belongs to the new WHO category of myeloid and lymphoid neoplasms with abnormalities in PDGFRA, PDGFRB and FGFR1 genes. Although such genetic mutations are prone to multi-lineage differentiation, the present case is in fact the first report of concurrent AML and T lymphoblastic lymphoma involving PDGFRB mutations. The patient was treated with cytarabine and daunomycin in combination with high dose dexamethasone. Allogeneic stem cell transplantation was performed after successful remission induction for both entities. The patient eventually died of chronic graft-versus-host-disease related infection. Based on such an experience, we suggest the decision of stem cell transplantation should be weighed carefully against the risks, especially when tyrosine kinase inhibitors are safe and potentially effective in dealing with such entities.
Source
Diagn Pathol. 2012 Feb 22;7:19. Link to article on publisher's site 2012 Chang et al; licensee BioMed Central Ltd.