High‐grade B‐cell lymphoma developed during the treatment of chronic myeloid leukemia with bosutinib

Abstract

Chronic myeloid leukemia (CML) accounts for approximately 15-20% of all leukemias in adults. 1 CML is characterized by the BCR-ABL1 fusion gene encoding a constitutively active tyrosine kinase. 2 Tyrosine kinase inhibitor (TKI) can help to improved the survival time in CML patients to expect almost normal life expectancy; however, the risk of secondary malignancies due to TKIs has not been completely eliminated. It is reported that second malignancies developed in 3.1-4.5%

Follicular Lymphoma Secondary to Chronic Myeloid Leukemia During Treatment With Imatinib

“…The majority of patients were treated for CML with imatinib, dasatinib, and then bosutinib before progressing to secondary malignancy. Table 1 shows all published cases of secondary lymphoma in CML patients, as well as their demographics and clinical characteristics [4][5][6][7][8][9][10][11][12]. T-cell, B-cell, and NK-cell function inhibition is thought to be the mechanism by which additional hematological malignancies develop in TKI-treated CML patients.…”

“…The majority of patients were treated for CML with imatinib, dasatinib, and then bosutinib before progressing to secondary malignancy. Table 1 shows all published cases of secondary lymphoma in CML patients, as well as their demographics and clinical characteristics [ 4 - 12 ].…”

Non-Hodgkin's lymphoma developed during imatinib mesylate treatment of chronic myeloid leukemia

“…7 However, a possible pathogenic link between the development of secondary tumors and IM has not yet been demonstrated. 2 Currently, there are no therapeutic approaches for lymphomas attributable to TKIs. The only treatment available is the same as that for novo lymphoma.…”

“…5 A few cases have been published in which patients developed lymphoma after exposure to a single BCR-ABL TKI. 2 Second lymphoma accounts for 5% of second malignancies. 2 Several types of lymphoma have been observed, including diffuse large B-cell lymphoma such as our case, chronic lymphocytic leukemia/small B-cell lymphoma (CLL/SLL-B), follicular lymphoma, and Hodgkin lymphoma.…”

“…1 Most adverse effects occur within the first two years after initiation of therapy, but late effects are now recognized. 2 Secondary malignancies due to ITKs are reported in 3.6–4.5% of cases, 3 5% of them occur as secondary lymphoma. 4 There are few case reports in the literature describing the occurrence of lymphoma after CML treatment.…”