Hypoplastic acute myeloid leukemia in an elderly patient. A long‐term partial remission with low‐dose prednisone and G‐CSF

Islam, Anwarul

doi:10.1002/ccr3.2204

Cited by 1 publication

(1 citation statement)

References 26 publications

(25 reference statements)

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“…The optimal management for hypocellular leukemia has not yet been established. The case of an elderly woman with successful control using low-dose granulocyte colony-stimulating factor and oral prednisolone has been reported (25). In our case, gradual recovery of hematopoietic function after steroid alone and rapid normalization of hematopoietic function after addition of dasatinib were observed.…”

Section: Discussionsupporting

confidence: 53%

Hypocellular Philadelphia chromosome‑positive mixed‑phenotype acute leukemia successfully treated with dasatinib: A case report

et al. 2021

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Both hypocellular leukemia and Philadelphia (Ph) chromosome-positive mixed-phenotype acute leukemia (MPAL) are rare subtypes of leukemia showing unfavorable outcomes and lacking established optimal management. Ph-positive leukemia most often presents with hypercellularity and hypoplasia is a rare condition. The present study reports an extremely rare case of hypocellular biclonal Ph-positive MPAL, which was diagnosed by biopsy and genetic analysis of bone marrow, and successfully treated with dasatinib and steroids. Briefly, a 77-year-old man presented with pancytopenia and flow cytometry of bone marrow could not be evaluated due to hypocellularity. The patient was finally diagnosed with hypocellular Ph-positive MPAL by genetic analysis and immunostaining of bone marrow biopsy. Although blood cells recovered with methylprednisolone pulse administration alone for concurrent optic neuritis, hematopoietic function rapidly normalized with dasatinib administered after definitive diagnosis of Ph-positive leukemia. Dasatinib and oral prednisolone were continued following methylprednisolone pulse administration and the patient achieved molecular complete remission (CR) on day 140 of treatment; molecular CR was maintained thereafter without any severe adverse events. In conclusion, the combination of dasatinib and a steroid may be one of the tolerable treatment options for elderly patients with hypocellular biclonal Ph-positive MPAL. Furthermore, genetic analysis and immunostaining of bone marrow biopsy can help with the diagnosis of leukemia with hypocellular bone marrow.

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Section: Discussionsupporting

confidence: 53%