Philadelphia chromosome-like acute lymphoblastic leukemia with concomitant rearrangements of CRLF2 and ABL1: a pediatric case report.
BMC Pediatr
; 24(1): 517, 2024 Aug 10.
Article
in En
| MEDLINE
| ID: mdl-39127642
ABSTRACT
BACKGROUND:
BCRABL1-like or Philadelphia chromosome-like (Ph-like) acute lymphoblastic leukemia (ALL) was first reported in 2009. Ph-like ALL is characterized by gene signature similar to Philadelphia chromosome ALL, but without BCRABL1 fusions. Molecularly, Ph-like ALL is divided into seven categories, with CRLF2 and ABL-class rearrangements being the two most common subtypes, exhibiting alterations in distinct downstream signaling cascades. CASE PRESENTATION We report a rare case of pediatric Ph-like ALL with concomitant CRLF2 and ABL1 rearrangements. CRLF2 was fused with P2RY8, its most common fusion partner, whereas ABL1 was fused with MYO18B, a novel fusion partner that has not been previously reported. The 4-year-old female patient was treated using the national multicenter CCCG-ALL-2020 protocol with the addition of dasatinib at the end of induction when ABL1 rearrangement was confirmed by RNA-seq. Morphologically and molecularly, the patient remained in continuous remission until the last follow-up. To the best of our knowledge, this is the first case of Ph-like ALL harboring two distinct rearrangement categories.CONCLUSIONS:
Our results identified that ABL1 rearrangement and CRLF2 rearrangement can coexist. The application of FISH, whole transcription sequencing, PCR can help us to have a more comprehensive understanding of ALL cytogenetics and molecular biology. Further studies are needed to explore the role of targeted therapies in such rare clinical scenarios.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Philadelphia Chromosome
/
Gene Rearrangement
/
Receptors, Cytokine
/
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Limits:
Child, preschool
/
Female
/
Humans
Language:
En
Journal:
BMC Pediatr
Journal subject:
PEDIATRIA
Year:
2024
Document type:
Article
Affiliation country:
China
Country of publication:
Reino Unido