Oiwa Kana, Lee Shin, Fujita Kei, Ueda Takanori, Yamauchi Takahiro
Division of Hematology and Oncology, University of Fukui, Japan.
Division of Internal Medicine, Osu Hospital, Japan.
Intern Med. 2024 Mar 1;63(5):729-732. doi: 10.2169/internalmedicine.2182-23. Epub 2023 Jul 19.
Most clonal cytogenetic abnormalities of Philadelphia-negative cells (CCA/Ph-) occurring during tyrosine kinase inhibitor (TKI) treatment are transient, and the development of secondary myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML) is rare, but the frequency and clinical significance in Japanese patients are still unknown. We herein report four patients who developed CCA/Ph- during TKI therapy and were diagnosed with secondary MDS/AML. The duration from TKI therapy initiation to MDS/AML onset ranged from 3 to 48 months, and the survival ranged from 5 to 84 months. The occurrence of CCA/Ph- with MDS/AML may be associated with a poor prognosis, and careful follow-up is recommended for patients who receive TKI therapy.
在酪氨酸激酶抑制剂(TKI)治疗期间出现的大多数费城染色体阴性细胞的克隆性细胞遗传学异常(CCA/Ph-)是短暂的,继发骨髓增生异常综合征(MDS)/急性髓系白血病(AML)的情况很少见,但在日本患者中的发生率和临床意义仍不清楚。我们在此报告4例在TKI治疗期间发生CCA/Ph-并被诊断为继发MDS/AML的患者。从开始TKI治疗到MDS/AML发病的时间为3至48个月,生存期为5至84个月。发生CCA/Ph-并伴有MDS/AML可能与预后不良有关,建议对接受TKI治疗的患者进行密切随访。