Case Report: CMML in Young Age which Transformed to AML
DOI:
https://doi.org/10.21776/ub.crjim.2023.004.02.08Keywords:
CMML, AML, ASLX1Abstract
CMML (Chronic Myelomonocytic Leukemia) is a rare type of blood cancer that characterized with the presents of monocytes in the blood. 1,2 According to WHO it is categorized as overlapped manifestation of MDS (Myelodysplastic Syndrome) and MPD (Myeloproliferative Disease) or MPN (Myeloproliferative Neoplasm). 2,3 The origin cause of CMML is gene mutation on TET2 (60 %), SRSF2 (50 %), ASLX1 (40 %), and RAS (30 %). 1,3,4 Men are predominantly affected with incidence peak between 71 and 74 years of age, and the prevalence on young adult are very rare and considered to be closely related to the presence of gene mutations in ASLX1. 1,3,5 From several case reports, there were 63 % of CMML patients changed into secondary AML within 1-5 years due to somatic gene mutations in the ASLX1. 2,3,4,6 In this case, we report a 21-year-old male who is diagnosed with CMML and eventually transformed to AML.
References
Arber DA, Orazi A, Hasserjian R, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 2016 May;127(20):2391–405.
Ball M, List AF, Padron E. When clinical heterogeneity exceeds genetic heterogeneity: thinking outside the genomic box in chronic myelomonocytic leukemia. Blood. 2016 Nov;128(20):2381–7.
McGrattan P, Humphreys M, Hull D, et al. Transformation of cytogenetically normal chronic myelomonocytic leukaemia to an acute myeloid leukaemia and the emergence of a novel +13, +15 double trisomy resulting in an adverse outcome. Ulster Med J. 2007 Sep;76(3):131–5.
Niscola P, Tendas A, Scaramucci L, et al. Acute myeloid leukemia arising from chronic myelomonocytic leukemia during hypomethylating therapy. Blood Res [Internet]. 2014/03/24. 2014 Mar;49(1):65–6. Available from: https://pubmed.ncbi.nlm.nih.gov/24724070
Patnaik MM, Lasho TL, Vijayvargiya P, et al. Prognostic interaction between ASXL1 and TET2 mutations in chronic myelomonocytic leukemia. Blood Cancer J. 2016 Jan;6(1):e385.
Hunter AM, Al Ali N, Sallman DA, et al. WHO-Defined Chronic Myelomonocytic Leukemia-2 (CMML-2) Patients Rapidly Progress to AML Suggesting This Entity Represents a Transitory Clinical State. Blood [Internet]. 2019 Nov 13;134(Supplement_1):1717. Available from: https://doi.org/10.1182/blood-2019-131071
DeBoer R, Garrahy I, Rettew A, et al. Transformation of CMML to AML presenting with acute kidney injury. J community Hosp Intern Med Perspect [Internet]. 2020 Aug 2;10(4):353–7. https://pubmed.ncbi.nlm.nih.gov/32850097
Clark MR. Chronic Myelomonocytic Leukemia Transforming Into Acute Myelogenous Leukemia. Lab Med [Internet]. 2009 Jan 1;40(1):19–21.
DOI: 10.1309/LMBP4DPLJ5G0WXQR
Patnaik MM, Wassie EA, Padron E, et al. Chronic myelomonocytic leukemia in younger patients: molecular and cytogenetic predictors of survival and treatment outcome. Blood Cancer J [Internet]. 2015;5:e280. Available from: https://europepmc.org/articles/PMC4349260
Peter Valent, Attilio Orazi, Michael R. Savona, et al. Proposed diagnostic criteria for classical chronic myelomonocytic leukemia (CMML), CMML variants and pre-CMML conditions. Haematologica [Internet]. 2019 Oct 1;104(10 SE-Guidelines):1935–49. Available from: https://haematologica.org/article/view/9078
Apperley JF, Gardembas M, Melo J V, et al. Response to imatinib mesylate in patients with chronic myeloproliferative diseases with rearrangements of the platelet-derived growth factor receptor beta. N Engl J Med. 2002 Aug;347(7):481–7.
Liu H, Cheng J, Zhao L, et al. Outcome of patient with high-risk chronic myelomonocytic leukemia, treated with decitabine prior to transformation to acute myeloid leukemia: A case report. Oncol Lett [Internet]. 2018/03/12. 2018 May;15(5):7132–8. Available from: https://pubmed.ncbi.nlm.nih.gov/29731877
Solary E, Itzykson R. How I treat chronic myelomonocytic leukemia. Blood. 2017 Jul;130(2):126–36.
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