Dasatinib
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Chemoresistance in T-cell acute lymphoblastic leukaemia: case report A 7-year-old boy developed resistance to dasatinib while being treated for T-cell acute lymphoblastic leukaemia (T-ALL). The boy, who had been diagnosed with T-ALL, was found to have NUP214-ABL1 fusion gene expression. He was treated with conventional ALL-type chemotherapy initially resulting in complete haematological remission. During the consolidation phase, NUP214-ABL1 fusion gene was undetectable in bone marrow. However, the gene was detectable again in the maintenance phase. A molecular relapse was considered, and he was treated with dasatinib [dosage and route not stated]. Two weeks after dasatinib initiation, the NUP214-ABL1 fusion gene disappeared. Four months after dasatinib initiation, 91.8% of lymphoblasts were noted in the bone marrow examination. The findings suggested T-ALL relapse. Reverse transcription PCR showed karyotype of lymphoblasts 47, XY, +8 in all 15 analysed cells with no NUP214-ABL1 fusion gene. During the relapse, in vitro drug testing revealed lymphoblasts which became resistant to dasatinib. The findings indicated chemoresistance to dasatinib. The boy was treated with nelarabine-containing chemotherapy, and a complete remission was achieved. Subsequently, he underwent bone marrow transplantation. Author comment: "In the in vitro drug sensitivity test, blasts at relapse became resistant to dasatinib compared to those at diagnosis". Tsurusaki Y, et al. Whole-exome sequencing reveals the subclonal expression of NUP214-ABL1 fusion gene in T-cell acute lymphoblastic leukemia. Pediatric Blood and Cancer 67: e28019, No. 1, Jan 2020. Available from: URL: http:// 803442243 doi.org/10.1002/pbc.28019 - Japan
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Reactions 4 Jan 2020 No. 1785
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