Isolated Central Nervous System Infiltrated and Progressed to Acute Myeloid Leukemia from Chronic Myeloid Leukemia with e1a3 BCR-ABL1 Transcript: A Rare Case Report and Literature Review
Xing Qiang, Qin Wen, Jia Li, Siyu Chen, Tinglu Tao, Hongyang Zhang, Ping Wang, Xiangui Peng, Yimei Feng, Xi Zhang Medical Center of Hematology, Xinqiao Hospital, Army Medical University, Chongqing, People’s Republic of ChinaCorrespondence: Xiangui Peng; Yimei Feng, Email P13983190510@163.com; yimeif...
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Dove Medical Press
2025-01-01
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| author | Qiang X Wen Q Li J Chen S Tao T Zhang H Wang P Peng X Feng Y Zhang X |
| author_facet | Qiang X Wen Q Li J Chen S Tao T Zhang H Wang P Peng X Feng Y Zhang X |
| author_sort | Qiang X |
| collection | DOAJ |
| description | Xing Qiang, Qin Wen, Jia Li, Siyu Chen, Tinglu Tao, Hongyang Zhang, Ping Wang, Xiangui Peng, Yimei Feng, Xi Zhang Medical Center of Hematology, Xinqiao Hospital, Army Medical University, Chongqing, People’s Republic of ChinaCorrespondence: Xiangui Peng; Yimei Feng, Email P13983190510@163.com; yimeifeng@163.comAbstract: The chronic myeloid leukemia (CML) is easily diagnosed by laboratory examination, however, rare BCR-ABL1 mRNA transcripts variants, such as e1a3 present diagnosis and therapeutic challenges. This case report details the diagnosis and management of a CML patient with the e1a3 transcript by FISH and RT-PCR. Following initial diagnosis, the patient was treated with the tyrosine kinase inhibitor (TKI) Flumatinib. During the treatment, although the FCM-MRD of the bone marrow kept negative, the e1a3 expression detected by PCR always remained positive. After eighteen months, the patient experienced headaches, vomiting, and blurred vision. Subsequent bone marrow analysis and flow cytometry detection of cerebrospinal fluid indicated that the patient had entered the blast phase, progressing to acute myeloid leukemia (AML). Treatment was switched to the third-generation TKI olverembatinib, combined with chemotherapy, followed by allogeneic hematopoietic stem cell transplantation. The patient remains disease-free following olverembatinib maintenance therapy. This case underscores the importance of comprehensive diagnostic apporsches and the potential efficacy of third-generation TKIs and allo-HSCT in the treatment of e1a3-type CML.Keywords: CML-BC, e1a3 transcript, CNS, HSCT, olverembatinib |
| format | Article |
| id | doaj-art-ac56207803ef484f81a2cf94d9d92f93 |
| institution | Kabale University |
| issn | 1179-1322 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Cancer Management and Research |
| spelling | doaj-art-ac56207803ef484f81a2cf94d9d92f932025-01-12T16:52:42ZengDove Medical PressCancer Management and Research1179-13222025-01-01Volume 17354399176Isolated Central Nervous System Infiltrated and Progressed to Acute Myeloid Leukemia from Chronic Myeloid Leukemia with e1a3 BCR-ABL1 Transcript: A Rare Case Report and Literature ReviewQiang XWen QLi JChen STao TZhang HWang PPeng XFeng YZhang XXing Qiang, Qin Wen, Jia Li, Siyu Chen, Tinglu Tao, Hongyang Zhang, Ping Wang, Xiangui Peng, Yimei Feng, Xi Zhang Medical Center of Hematology, Xinqiao Hospital, Army Medical University, Chongqing, People’s Republic of ChinaCorrespondence: Xiangui Peng; Yimei Feng, Email P13983190510@163.com; yimeifeng@163.comAbstract: The chronic myeloid leukemia (CML) is easily diagnosed by laboratory examination, however, rare BCR-ABL1 mRNA transcripts variants, such as e1a3 present diagnosis and therapeutic challenges. This case report details the diagnosis and management of a CML patient with the e1a3 transcript by FISH and RT-PCR. Following initial diagnosis, the patient was treated with the tyrosine kinase inhibitor (TKI) Flumatinib. During the treatment, although the FCM-MRD of the bone marrow kept negative, the e1a3 expression detected by PCR always remained positive. After eighteen months, the patient experienced headaches, vomiting, and blurred vision. Subsequent bone marrow analysis and flow cytometry detection of cerebrospinal fluid indicated that the patient had entered the blast phase, progressing to acute myeloid leukemia (AML). Treatment was switched to the third-generation TKI olverembatinib, combined with chemotherapy, followed by allogeneic hematopoietic stem cell transplantation. The patient remains disease-free following olverembatinib maintenance therapy. This case underscores the importance of comprehensive diagnostic apporsches and the potential efficacy of third-generation TKIs and allo-HSCT in the treatment of e1a3-type CML.Keywords: CML-BC, e1a3 transcript, CNS, HSCT, olverembatinibhttps://www.dovepress.com/isolated-central-nervous-system-infiltrated-and-progressed-to-acute-my-peer-reviewed-fulltext-article-CMARcml-bce1a3 transcriptcnshsctolverembatinib. |
| spellingShingle | Qiang X Wen Q Li J Chen S Tao T Zhang H Wang P Peng X Feng Y Zhang X Isolated Central Nervous System Infiltrated and Progressed to Acute Myeloid Leukemia from Chronic Myeloid Leukemia with e1a3 BCR-ABL1 Transcript: A Rare Case Report and Literature Review Cancer Management and Research cml-bc e1a3 transcript cns hsct olverembatinib. |
| title | Isolated Central Nervous System Infiltrated and Progressed to Acute Myeloid Leukemia from Chronic Myeloid Leukemia with e1a3 BCR-ABL1 Transcript: A Rare Case Report and Literature Review |
| title_full | Isolated Central Nervous System Infiltrated and Progressed to Acute Myeloid Leukemia from Chronic Myeloid Leukemia with e1a3 BCR-ABL1 Transcript: A Rare Case Report and Literature Review |
| title_fullStr | Isolated Central Nervous System Infiltrated and Progressed to Acute Myeloid Leukemia from Chronic Myeloid Leukemia with e1a3 BCR-ABL1 Transcript: A Rare Case Report and Literature Review |
| title_full_unstemmed | Isolated Central Nervous System Infiltrated and Progressed to Acute Myeloid Leukemia from Chronic Myeloid Leukemia with e1a3 BCR-ABL1 Transcript: A Rare Case Report and Literature Review |
| title_short | Isolated Central Nervous System Infiltrated and Progressed to Acute Myeloid Leukemia from Chronic Myeloid Leukemia with e1a3 BCR-ABL1 Transcript: A Rare Case Report and Literature Review |
| title_sort | isolated central nervous system infiltrated and progressed to acute myeloid leukemia from chronic myeloid leukemia with e1a3 bcr abl1 transcript a rare case report and literature review |
| topic | cml-bc e1a3 transcript cns hsct olverembatinib. |
| url | https://www.dovepress.com/isolated-central-nervous-system-infiltrated-and-progressed-to-acute-my-peer-reviewed-fulltext-article-CMAR |
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