Diagnostics and treatment challenges of Ph-like acute lymphoblastic leukemia: a description of 3 clinical cases


Cite item

Full Text

Abstract

B-cell acute lymphoblastic leukemia (B-ALL) is a diverse group of malignant blood disorders both with regard to the biological properties of the tumor and to therapeutic approaches. Immunophenotyping, molecular genetic techniques, whole-genome sequencing characterize B-ALL as a very diverse group for sensitivity to chemotherapy and prognosis. We present three clinical cases of patients with B-ALL and expected good response to standard therapy, in whom standard protocol treatment failured: refractoriness, persistence of minimal residual disease (MRD), and progression (MRD increase). The remission in these patients was achieved after chemotherapy change to immunological targeted therapy. Nowadays a unified therapeutic approach to all primary patients of the B-ALL is considered generally outdated. Great efforts are carrying out to develop molecular genetic classifications. The molecular dissection of subtypes of B-ALL goes on, and new protocols for selective treatment with targeting are clearly outlined for each subtype of B-ALL.

About the authors

K I ZARUBINA

National Research Center for Hematology

Email: ksenijazarubina@mail.com
врач-гематолог, аспирант отд-ния интенсивной терапии гемобластозов и депрессий кроветворения со стационаром дневного пребывания; http://orcid.org/0000-0003-2947-6398 Moscow, Russia

E N PAROVICHNIKOVA

National Research Center for Hematology

д.м.н., проф., руководитель отдела химиотерапии гемобластозов, депрессий кроветворения и ТКМ ФГБУ «НМИЦ гематологии» МЗ РФ, http://orcid.org/0000-0001-6177-3566 Moscow, Russia

G A BASKHAEVA

National Research Center for Hematology

аспирант, врач-гематолог отд-ния интенсивной высокодозной химиотерапии гемобластозов и депрессий кроветворения с круглосуточным и дневным стационарами ФГБУ «НМИЦ гематологии» МЗ РФ, https://orcid.org/0000-0003-2763-5391 Moscow, Russia

A E KRASILNIKOVA

National Research Center for Hematology

клинический ординатор отд-ния интенсивной высокодозной химиотерапии гемобластозов и депрессий кроветворения с круглосуточным и дневным стационарами ФГБУ «НМИЦ гематологии» МЗ РФ, https://orcid.org/0000-0001-6230-6513 Moscow, Russia

O A GAVRILINA

National Research Center for Hematology

к.м.н., врач-гематолог, с.н.с. отд-ния интенсивной высокодозной химиотерапии гемобластозов и депрессий кроветворения с круглосуточным и дневным стационарами ФГБУ «НМИЦ гематологии» МЗ РФ, http://orcid.org/0000-0002-9969-8482 Moscow, Russia

B V BIDERMAN

National Research Center for Hematology

к.б.н., с.н.с. научно-клинической лаборатории молекулярной гематологии ФГБУ «НМИЦ гематологии» МЗ РФ, http://orcid.org/0000-0002-6253-3334 Moscow, Russia

A B SUDARIKOV

National Research Center for Hematology

д.б.н., зав. научно-клинической лаборатории молекулярной гематологии ФГБУ «НМИЦ гематологии» МЗ РФ, https://orcid.org/0000-0001-9463-9187 Moscow, Russia

S N BONDARENKO

Pavlov First Saint Petersburg State Medical University

к.м.н. доцент каф. гематологии, трансфузиологии и трансплантологии ФПО Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П.Павлова Saint Petersburg, Russia

Y O DAVYDOVA

National Research Center for Hematology

врач КДЛ, лаборатория иммунофенотипирования клеток крови и костного мозга ФГБУ «НМИЦ гематологии» МЗ РФ, https://orcid.org/0000-0001-5932-0285 Moscow, Russia

I V GALTSEVA

National Research Center for Hematology

д.б.н., зав. научно-клинической лаборатории молекулярной гематологии ФГБУ «НМИЦ гематологии» МЗ РФ, https://orcid.org/0000-0001-9463-9187 Moscow, Russia

A N SOKOLOV

National Research Center for Hematology

к.м.н., с.н.с. отд-ния интенсивной высокодозной химиотерапии гемобластозов и депрессий кроветворения с круглосуточным и дневным стационарами ФГБУ «НМИЦ гематологии» МЗ РФ, http://orcid.org/0000-0003-1494-7978 Moscow, Russia

V V TROITSKAYA

National Research Center for Hematology

к.м.н., зав. отд-нием высокодозной химиотерапии гемобластозов и депрессий кроветворения с круглосуточным и дневным стационарами ФГБУ «НМИЦ гематологии» МЗ РФ, http://orcid.org/0000-0002-4827-8947 Moscow, Russia

V G SAVCHENKO

National Research Center for Hematology

проф., академик РАН, д.м.н., директор ФГБУ «НМИЦ гематологии» МЗ РФ, http://orcid.org/0000-0001-8188-5557 Moscow, Russia

References

  1. Thomas D, O'Brien S, Faderl S, Garcia-Manero G, Ferrajoli A, Wierda W, Ravandi F, Verstovsek S, Jorgensen J, Bueso-Ramos C, Andreeff M, Pierce S, Garris R, Keating M, Cortes J and Kantarjian H. Chemoimmunotherapy With a Modified Hyper-CVAD and Rituximab Regimen Improves Outcome in De Novo Philadelphia Chromosome-Negative Precursor B-Lineage Acute Lymphoblastic Leukemia. Journal of Clinical Oncology. 2010; 28(24):3880-3889. https://doi.org/10.1200/ JCO.2009.26.9456
  2. Moorman A.V. The clinical relevance of chromosomal and genomic abnormalities in B-cell precursor acute lymphoblastic leukaemia. Blood Reviews. 2012;26(3):123-135. https://doi.org/10.1016/j.blre.2012. 01.001
  3. Den Boer M.L, van Slegtenhorst M, De Menezes R.X, Cheok M.H, Buijs-Gladdines J.G, Peters S.T, Van Zutven L.J, Beverloo H.B, Van der Spek P.J, Escherich G, Horstmann M.A, Janka-Schaub G.E, Kamps W.A, Evans W.E, Pieters R. A subtype of childhood acute lymphoblastic leukaemia with poor treatment outcome: a genome - wide classification study. The Lancet Oncology. 2009;10(2):125-134. https://doi.org/10. 1016/S1470-2045(08)70339-5
  4. Mullighan C.G, Su X, Zhang J, Radtke I, Phillips L.A, Miller C.B, Ma J, Liu W, Cheng C, Schulman B.A, Harvey R.C, Chen I.M, Clifford R.J, Carroll W.L, Reaman G, Bowman W.P, Devidas M, Gerhard D.S, Yang W, Relling M.V, Shurtleff S.A, Campana D, Borowitz M.J, Pui C.H, Smith M, Hunger S.P, Willman C.L, Downing J.R; Children's Oncology Group. Deletion of IKZF1and Prognosis in Acute Lymphoblastic Leukemia. New England Journal of Medicine. 2009;360(5):470-480. https://doi.org/10.1056/nejmoa0808253
  5. Roberts K.G, Li Y, Payne-Turner D, Harvey R.C, Yang Y.L, Pei D, Mc Castlain K, Ding L, Lu C, Song G, Ma J, Becksfort J, Rusch M, Chen S.C, Easton J, Cheng J, Boggs K, Santiago-Morales N, Iacobucci I, Fulton R.S, Wen J, Valentine M, Cheng C, Paugh S.W, Devidas M, Chen I.M, Reshmi S, Smith A, Hedlund E, Gupta P, Nagahawatte P, Wu G, Chen X, Yergeau D, Vadodaria B, Mulder H, Winick N.J, Larsen E.C, Carroll W.L, Heerema N.A, Carroll A.J, Grayson G, Tasian S.K, Moore A.S, Keller F, Frei-Jones M, Whitlock J.A, Raetz E.A, White D.L, Hughes T.P, Guidry Auvil J.M, Smith M.A, Marcucci G, Bloomfield C.D, Mrózek K, Kohlschmidt J, Stock W, Kornblau S.M, Konopleva M, Paietta E, Pui C.H, Jeha S, Relling M.V, Evans W.E, Gerhard D.S, Gastier-Foster J.M, Mardis E, Wilson R.K, Loh M.L, Downing J.R, Hunger S.P, Willman C.L, Zhang J, Mullighan C.G. Targetable Kinase-Activating Lesions in Ph - like Acute Lymphoblastic Leukemia. New England Journal of Medicine. 2014;371(11):1005-1015. https://doi.org/10.1056/nejmoa1403088
  6. Herold T, Baldus C, Gökbuget N. Ph - like Acute Lymphoblastic Leukemia in Older Adults. New England Journal of Medicine. 2014;371(23):2235-2235. https://doi.org/10.1056/nejmc1412123
  7. Herold T, Schneider S, Metzeler K.H, Neumann M, Hartmann L, Roberts K.G, Konstandin N.P, Greif P.A, Bräundl K, Ksienzyk B, Huk N., Schneider I, Zellmeier E, Jurinovic V, Mansmann U, Hiddemann W, Mullighan C.G, Bohlander S.K, Spiekermann K, Hoelzer D, Brüggemann M, Baldus C.D, Dreyling M, Gökbuget N. Adults with Philadelphia chromosome - like acute lymphoblastic leukemia frequently have IGH-CRLF2 and JAK2 mutations, persistence of minimal residual disease and poor prognosis. Haematologica. 2016;102(1):130-138. https://doi.org/10.3324/haematol.2015.136366
  8. Jain N, Roberts K.G, Jabbour E, Patel K, Eterovic A.K, Chen K, Zweidler-Mc Kay P, Lu X, Fawcett G, Wang S.A, Konoplev S, Harvey R.C, Chen I.M, Payne-Turner D, Valentine M, Thomas D, Garcia-Manero G, Ravandi F, Cortes J, Kornblau S, O'Brien S, Pierce S, Jorgensen J, Shaw K.R, Willman C.L, Mullighan C.G, Kantarjian H, Konopleva M. Ph - like acute lymphoblastic leukemia: a high - risk subtype in adults. Blood. 2016;129(5):572-581. https://doi.org/10.1182/blood-2016-07-726588
  9. Roberts K.G, Gu Z, Payne-Turner D, Mc Castlain K, Harvey R.C, Chen I.M, Pei D, Iacobucci I, Valentine M, Pounds S.B, Shi L, Li Y, Zhang J, Cheng C, Rambaldi A, Tosi M, Spinelli O, Radich J.P, Minden M.D, Rowe J.M, Luger S, Litzow M.R, Tallman M.S, Wiernik P.H, Bhatia R, Aldoss I, Kohlschmidt J, Mrózek K, Marcucci G, Bloomfield C.D, Stock W, Kornblau S, Kantarjian H.M, Konopleva M, Paietta E, Willman C.L, Mullighan C.G. Roberts K, Gu Z, Payne-Turner D et al. High Frequency and Poor Outcome of Philadelphia Chromosome-Like Acute Lymphoblastic Leukemia in Adults. Journal of Clinical Oncology. 2017;35(4):394-401. https://doi.org/10.1200/jco.2016.69.0073
  10. Boer J.M, Koenders J.E, van der Holt B, Exalto C, Sanders M.A, Cornelissen J.J, Valk P.J, den Boer M.L, Rijneveld A.W. Expression profiling of adult acute lymphoblastic leukemia identifies a BCR-ABL1-like subgroup characterized by high non - response and relapse rates. Haematologica. 2015;100(7):e261-e264. https://doi.org/10.3324/ haematol.2014.117424
  11. Imamura T, Kiyokawa N, Kato M, Imai C, Okamoto Y, Yano M, Ohki K, Yamashita Y, Kodama Y, Saito A, Mori M, Ishimaru S, Deguchi T, Hashii Y, Shimomura Y, Hori T, Kato K, Goto H, Ogawa C, Koh K, Taki T, Manabe A, Sato A, Kikuta A, Adachi S, Horibe K, Ohara A, Watanabe A, Kawano Y, Ishii E, Shimada H. Characterization of pediatric Philadelphia - negative B-cell precursor acute lymphoblastic leukemia with kinase fusions in Japan. Blood Cancer J. 2016;6(5): e419-e419. https://doi.org/10.1038/bcj.2016.28
  12. van der Veer A, Waanders E, Pieters R, Willemse M.E, Van Reijmersdal S.V, Russell L.J, Harrison C.J, Evans W.E, van der Velden V.H, Hoogerbrugge P.M, Van Leeuwen F, Escherich G, Horstmann M.A, Mohammadi Khankahdani L, Rizopoulos D, De Groot-Kruseman H.A, Sonneveld E, Kuiper R.P, Den Boer M.L. Independent prognostic value of BCR-ABL1-like signature and IKZF1 deletion, but not high CRLF2 expression, in children with B-cell precursor ALL. Blood. 2013;122(15):2622-2629. https://doi.org/10.1182/blood-2012-10-462 358
  13. Loh M.L, Zhang J, Harvey R.C, Roberts K, Payne-Turner D, Kang H, Wu G, Chen X, Becksfort J, Edmonson M, Buetow K.H, Carroll W.L, Chen I.M, Wood B, Borowitz M.J, Devidas M, Gerhard D.S, Bowman P, Larsen E, Winick N, Raetz E, Smith M, Downing J.R, Willman C.L, Mullighan C.G, Hunger S.P. Tyrosine kinome sequencing of pediatric acute lymphoblastic leukemia: a report from the Children's Oncology Group TARGET Project. Blood. 2012;121(3):485-488. https://doi.org/ 10.1182/blood-2012-04-422691
  14. Harvey R.C, Mullighan C.G, Chen I.M, Wharton W, Mikhail F.M, Carroll A.J, Kang H, Liu W, Dobbin K.K, Smith M.A, Carroll W.L, Devidas M, Bowman W.P, Camitta B.M, Reaman G.H, Hunger S.P, Downing J.R, Willman C.L. Rearrangement of CRLF2 is associated with mutation of JAK kinases, alteration of IKZF1, Hispanic/Latino ethnicity, and a poor outcome in pediatric B-progenitor acute lymphoblastic leukemia. Blood. 2010;115(26):5312-5321. https://doi.org/10.1182/blood-2009-09-245944
  15. Boer J.M, Marchante J.R, Evans W.E, Horstmann M.A, Escherich G, Pieters R, Den Boer M.L. CR-ABL1-like cases in pediatric acute lymphoblastic leukemia: a comparison between DCOG/Erasmus MC and COG/St. Jude signatures. Haematologica. 2015;100(9):e354-e357. https://doi.org/10.3324/haematol.2015.124941
  16. Russell L.J, Capasso M, Vater I, Akasaka T, Bernard O.A, Calasanz M.J, Chandrasekaran T, Chapiro E, Gesk S, Griffiths M, Guttery D.S, Haferlach C, Harder L, Heidenreich O, Irving J, Kearney L, Nguyen-Khac F, Machado L, Minto L, Majid A, Moorman A.V, Morrison H, Rand V, Strefford J.C, Schwab C, Tönnies H, Dyer M.J, Siebert R, Harrison C.J. Deregulated expression of cytokine receptor gene, CRLF2, is involved in lymphoid transformation in B-cell precursor acute lymphoblastic leukemia. Blood. 2009;114(13):2688-2698. https://doi.org/10.1182/ blood-2009-03-208397
  17. Mullighan C.G, Collins-Underwood J.R, Phillips L.A, Loudin M.G, Liu W, Zhang J, Ma J, Coustan-Smith E, Harvey R.C, Willman C.L, Mikhail F.M, Meyer J, Carroll A.J, Williams R.T, Cheng J, Heerema N.A, Basso G, Pession A, Pui C.H, Raimondi S.C, Hunger S.P, Downing J.R, Carroll W.L, Rabin K.R. Rearrangement of CRLF2 in B-progenitor - and Down syndrome - associated acute lymphoblastic leukemia. Nat Genet. 2009;41(11):1243-1246. https://doi.org/10.1038/ng.469
  18. Mullighan C.G, Zhang J, Harvey R.C, Collins-Underwood J.R, Schulman B.A, Phillips L.A, Tasian S.K, Loh M.L, Su X, Liu W, Devidas M, Atlas S.R, Chen I.M, Clifford R.J, Gerhard D.S, Carroll W.L, Reaman G.H, Smith M, Downing J.R, Hunger S.P, Willman C.L. JAK mutations in high - risk childhood acute lymphoblastic leukemia. Proceedings of the National Academy of Sciences. 2009;106(23):9414-9418. https://doi.org 10.1073/pnas.0811761106
  19. Weston B.W, Hayden M.A, Roberts K.G, Bowyer S, Hsu J, Fedoriw G, Rao K.W, Mullighan C.G. Tyrosine Kinase Inhibitor Therapy Induces Remission in a Patient With Refractory EBF1-PDGFRB-Positive Acute Lymphoblastic Leukemia. Journal of Clinical Oncology. 2013;31(25):e413-e416. https://doi.org 10.1200/jco.2012.47.6770
  20. Lengline E, Beldjord K, Dombret H, Soulier J, Boissel N, Clappier E. Successful tyrosine kinase inhibitor therapy in a refractory B-cell precursor acute lymphoblastic leukemia with EBF1-PDGFRB fusion. Haematologica. 2013;98(11):e146-e148. https://doi.org 10.3324/ haematol.2013.095372
  21. Roberts K.G, Morin R.D, Zhang J, Hirst M, Zhao Y, Su X, Chen S.C, Payne-Turner D, Churchman M.L, Harvey R.C, Chen X, Kasap C, Yan C, Becksfort J, Finney R.P, Teachey D.T, Maude S.L, Tse K, Moore R, Jones S, Mungall K, Birol I, Edmonson M.N, Hu Y, Buetow K.E, Chen I.M, Carroll W.L, Wei L, Ma J, Kleppe M, Levine R.L, Garcia-Manero G, Larsen E, Shah N.P, Devidas M, Reaman G, Smith M, Paugh S.W, Evans W.E, Grupp S.A, Jeha S, Pui C.H, Gerhard D.S, Downing J.R, Willman C.L, Loh M, Hunger S.P, Marra M.A, Mullighan C.G. Genetic Alterations Activating Kinase and Cytokine Receptor Signaling in High-Risk Acute Lymphoblastic Leukemia. Cancer Cell. 2012;22(2):153-166. https://doi.org 10.1016/j.ccr.2012.06.005
  22. Maude S.L, Dolai S, Delgado-Martin C, Vincent T, Robbins A, Selvanathan A, Ryan T, Hall J, Wood A.C, Tasian S.K, Hunger S.P, Loh M.L, Mullighan C.G, Wood B.L, Hermiston M.L, Grupp S.A, Lock R.B, Teachey D.T. Efficacy of JAK/STAT pathway inhibition in murine xenograft models of early T-cell precursor (ETP) acute lymphoblastic leukemia. Blood. 2015;125(11):1759-1767. https://doi.org 10.1182/ blood-2014-06-580480
  23. Wilhelm S.M, Carter C, Tang L, Wilkie D, Mc Nabola A, Rong H, Chen C, Zhang X, Vincent P, Mc Hugh M, Cao Y, Shujath J, Gawlak S, Eveleigh D, Rowley B, Liu L, Adnane L, Lynch M, Auclair D, Taylor I, Gedrich R, Voznesensky A, Riedl B, Post L.E, Bollag G, Trail P.A. BAY 43-9006 Exhibits Broad Spectrum Oral Antitumor Activity and Targets the RAF/MEK/ERK Pathway and Receptor Tyrosine Kinases Involved in Tumor Progression and Angiogenesis. Cancer Res. 2004; 64(19):7099-7109. https://doi.org 10.1158/0008-5472.can-04-1443
  24. Roberts K, Mullighan C. Genomics in acute lymphoblastic leukaemia: insights and treatment implications. Nature Reviews Clinical Oncology. 2015;12(6):344-357. https://doi.org 10.1038/nrclinonc.2015.38
  25. Pui C, Roberts K, Yang J, Mullighan C. Philadelphia Chromosome - like Acute Lymphoblastic Leukemia. Clinical Lymphoma Myeloma and Leukemia. 2017;17(8):464-470. https://doi.org 10.1016/j.clml. 2017.03.299
  26. Churchman M.L, Evans K, Richmond J, Robbins A, Jones L, Shapiro I.M, Pachter J.A, Weaver D.T, Houghton P.J, Smith M.A, Lock R.B, Mullighan C.G. Synergism of FAK and tyrosine kinase inhibition in Ph+ B-ALL. JCI Insight. 2016;1(4). https://doi.org 10.1172/jci.insight.86082
  27. Churchman M.L, Low J, Qu C, Paietta E.M, Kasper L.H, Chang Y, Payne-Turner D, Althoff M.J, Song G, Chen S.C, Ma J, Rusch M, Mc Goldrick D, Edmonson M, Gupta P, Wang Y.D, Caufield W, Freeman B, Li L, Panetta J.C, Baker S, Yang Y.L, Roberts K.G, Mc Castlain K, Iacobucci I, Peters J.L, Centonze V.E, Notta F, Dobson S.M, Zandi S, Dick J.E, Janke L, Peng J, Kodali K, Pagala V, Min J, Mayasundari A, Williams R.T, Willman C.L, Rowe J, Luger S, Dickins R.A, Guy R.K, Chen T, Mullighan C.G. Efficacy of Retinoids in IKZF1-Mutated BCR-ABL1 Acute Lymphoblastic Leukemia. Cancer Cell. 2015;28(3):343-356. https://doi.org 10.1016/j.ccell.2015.07.016
  28. Kantarjian H, Stein A, Gökbuget N, Fielding A.K, Schuh A.C, Ribera J.M, Wei A, Dombret H, Foà R, Bassan R, Arslan Ö, Sanz M.A, Bergeron J, Demirkan F, Lech-Maranda E, Rambaldi A, Thomas X, Horst H.A, Brüggemann M, Klapper W, Wood B.L, Fleishman A, Nagorsen D, Holland C, Zimmerman Z, Topp M.S. Blinatumomab versus Chemotherapy for Advanced Acute Lymphoblastic Leukemia. New England Journal of Medicine. 2017;376(9):836-847. https://doi.org 10.1056/nejmoa1609783
  29. Sokolov A.N, Parovichnikova E.N, Troitskaya V.V, Kuzmina L.A, Galtseva I.V, Kulikov S.M, Bondarenko S.N, Davidova J.O, Kapranov N.M, Lukyanova I.A, Lobanova T.I, Usikova E.I, Zarubina K.I, Savchenko V.G. Blinatumomab + Tyrosine Kinase Inhibitors with No Chemotherapy in BCR-ABL-Positive or IKZF1-Deleted or FLT3-ITD-Positive Relapsed/Refractory Acute Lymphoblastic Leukemia Patients: High Molecular Remission Rate and Toxicity Profile. Blood. 2017;130:3884.
  30. Sokolov A, Parovichnikova E, Troitskaya V, Galtseva I, Kuzmina L, Davidova J, Kapranov N, Lukyanova I, Lobanova T, Zarubina K, Usikova E, Savchenko V. Targetable blinatumomab + tyrosine kinase inhibitors treatment in relapsed/refractory acute lymphoblastic leukemia patients: clinical effectiveness and peripheral lymphocytes subpopulations kinetics. Haematologica. 2017; 102(s2):354-355.

Copyright (c) 2018 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 
 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies