Abstract
We report on the emergence and clinical relevance of an unusual BCR-ABL1 kinase domain mutational status in a 2-year-old female with p210-BCR-ABL Philadelphia chromosome-positive acute lymphoblastic leukaemia. We detected three BCR-ABL1 clones determined by the presence of the E255V, D276G and F317L mutations. We point out the usefulness of searching for mutated populations that survive tyrosine-kinase inhibitor therapy and the role of their clonal selection over time in relation to therapeutic intervention.
© 2015 S. Karger AG, Basel.
MeSH terms
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Amino Acid Substitution
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Antineoplastic Agents / therapeutic use*
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Bone Marrow Transplantation
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Child, Preschool
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Clone Cells
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Combined Modality Therapy
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Drug Monitoring
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Drug Resistance, Multiple
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Drug Resistance, Neoplasm*
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Fatal Outcome
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Female
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Fusion Proteins, bcr-abl / antagonists & inhibitors
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Fusion Proteins, bcr-abl / genetics*
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Fusion Proteins, bcr-abl / metabolism
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Humans
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Lymphocyte Transfusion
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Philadelphia Chromosome*
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Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
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Precursor Cell Lymphoblastic Leukemia-Lymphoma / genetics*
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Precursor Cell Lymphoblastic Leukemia-Lymphoma / pathology
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Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy
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Protein Kinase Inhibitors / therapeutic use*
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Recurrence
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Transplantation, Homologous
Substances
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Antineoplastic Agents
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BCR-ABL1 fusion protein, human
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Protein Kinase Inhibitors
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Fusion Proteins, bcr-abl