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Consider High-Intensity Chemo + TKI in These Patients

Am J Hematol; ePub 2017 Apr 6; Salem, et al

Publish date:

The co-existence of BCR-ABL1 and CBFB chromosomal rearrangement is linked with poor outcome in patients with myeloid neoplasms, according to a small study involving 10 individuals.

Participants—who ranged between 20 and 71 years of age—had myeloid neoplasms harboring BCR-ABL1 and CBFB rearrangement. Among the results:

  • Of the 9 cases in which alterations could be determined, BCR-ABL1 preceded CBFB rearrangement in 7; CBFB preceded BCR-ABL1 in 1; and both alterations were discovered simultaneously in 1.
  • 2 patients were treated with fludarabine, cytarabine, idarubicin, and granulocyte colony-stimulating factor, along with a tyrosine kinase inhibitor (TKI).
  • 7 received other cytarabine-based regimens and TKIs.
  • 1 received ponatinib alone.
  • At 16 months follow-up 3 patients remained alive.

The authors noted that their findings show a clinical course similar to that of blast phase chronic myeloid leukemia, and unlike de novo acute myeloid leukemia with CBFB rearrangement. Thus, high-intensity chemotherapy with a TKI should be considered.

Citation:

Salem A, Loghavi S, Tang G, et al. Myeloid neoplasms with concurrent BCR-ABL1 and CBFB rearrangements: A series of 10 cases of a clinically aggressive neoplasm. [Published online ahead of print April 6, 2017]. Am J Hematol. doi:10.1002/ajh.24710.

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