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Molecular and Clinical Oncology
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Print ISSN: 2049-9450 Online ISSN: 2049-9469
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February-2022 Volume 16 Issue 2

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Case Report

Hypocellular Philadelphia chromosome‑positive mixed‑phenotype acute leukemia successfully treated with dasatinib: A case report

  • Authors:
    • Shin Lee
    • Kei Fujita
    • Hiroto Wakayama
    • Yusuke Kito
    • Takeshi Hara
    • Hisashi Tsurumi
  • View Affiliations / Copyright

    Affiliations: Department of Hematology and Oncology, Matsunami General Hospital, Gifu 501‑6062, Japan, Department of Pathology, Matsunami General Hospital, Gifu 501‑6062, Japan
  • Article Number: 33
    |
    Published online on: December 14, 2021
       https://doi.org/10.3892/mco.2021.2466
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Abstract

Both hypocellular leukemia and Philadelphia (Ph) chromosome‑positive mixed‑phenotype acute leukemia (MPAL) are rare subtypes of leukemia showing unfavorable outcomes and lacking established optimal management. Ph‑positive leukemia most often presents with hypercellularity and hypoplasia is a rare condition. The present study reports an extremely rare case of hypocellular biclonal Ph‑positive MPAL, which was diagnosed by biopsy and genetic analysis of bone marrow, and successfully treated with dasatinib and steroids. Briefly, a 77‑year‑old man presented with pancytopenia and flow cytometry of bone marrow could not be evaluated due to hypocellularity. The patient was finally diagnosed with hypocellular Ph‑positive MPAL by genetic analysis and immunostaining of bone marrow biopsy. Although blood cells recovered with methylprednisolone pulse administration alone for concurrent optic neuritis, hematopoietic function rapidly normalized with dasatinib administered after definitive diagnosis of Ph‑positive leukemia. Dasatinib and oral prednisolone were continued following methylprednisolone pulse administration and the patient achieved molecular complete remission (CR) on day 140 of treatment; molecular CR was maintained thereafter without any severe adverse events. In conclusion, the combination of dasatinib and a steroid may be one of the tolerable treatment options for elderly patients with hypocellular biclonal Ph‑positive MPAL. Furthermore, genetic analysis and immunostaining of bone marrow biopsy can help with the diagnosis of leukemia with hypocellular bone marrow.
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Copy and paste a formatted citation
Spandidos Publications style
Lee S, Fujita K, Wakayama H, Kito Y, Hara T and Tsurumi H: Hypocellular Philadelphia chromosome‑positive mixed‑phenotype acute leukemia successfully treated with dasatinib: A case report. Mol Clin Oncol 16: 33, 2022.
APA
Lee, S., Fujita, K., Wakayama, H., Kito, Y., Hara, T., & Tsurumi, H. (2022). Hypocellular Philadelphia chromosome‑positive mixed‑phenotype acute leukemia successfully treated with dasatinib: A case report. Molecular and Clinical Oncology, 16, 33. https://doi.org/10.3892/mco.2021.2466
MLA
Lee, S., Fujita, K., Wakayama, H., Kito, Y., Hara, T., Tsurumi, H."Hypocellular Philadelphia chromosome‑positive mixed‑phenotype acute leukemia successfully treated with dasatinib: A case report". Molecular and Clinical Oncology 16.2 (2022): 33.
Chicago
Lee, S., Fujita, K., Wakayama, H., Kito, Y., Hara, T., Tsurumi, H."Hypocellular Philadelphia chromosome‑positive mixed‑phenotype acute leukemia successfully treated with dasatinib: A case report". Molecular and Clinical Oncology 16, no. 2 (2022): 33. https://doi.org/10.3892/mco.2021.2466
Copy and paste a formatted citation
x
Spandidos Publications style
Lee S, Fujita K, Wakayama H, Kito Y, Hara T and Tsurumi H: Hypocellular Philadelphia chromosome‑positive mixed‑phenotype acute leukemia successfully treated with dasatinib: A case report. Mol Clin Oncol 16: 33, 2022.
APA
Lee, S., Fujita, K., Wakayama, H., Kito, Y., Hara, T., & Tsurumi, H. (2022). Hypocellular Philadelphia chromosome‑positive mixed‑phenotype acute leukemia successfully treated with dasatinib: A case report. Molecular and Clinical Oncology, 16, 33. https://doi.org/10.3892/mco.2021.2466
MLA
Lee, S., Fujita, K., Wakayama, H., Kito, Y., Hara, T., Tsurumi, H."Hypocellular Philadelphia chromosome‑positive mixed‑phenotype acute leukemia successfully treated with dasatinib: A case report". Molecular and Clinical Oncology 16.2 (2022): 33.
Chicago
Lee, S., Fujita, K., Wakayama, H., Kito, Y., Hara, T., Tsurumi, H."Hypocellular Philadelphia chromosome‑positive mixed‑phenotype acute leukemia successfully treated with dasatinib: A case report". Molecular and Clinical Oncology 16, no. 2 (2022): 33. https://doi.org/10.3892/mco.2021.2466
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