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A Novel BCR-ABL1 Mutation in a Patient with Philadelphia Chromosome-Positive B-Cell Acute Lymphoblastic Leukemia

dc.contributor.authorVinhas, R
dc.contributor.authorLourenço, A
dc.contributor.authorSantos, S
dc.contributor.authorLemos, M
dc.contributor.authorRibeiro, P
dc.contributor.authorBotelho de Sousa, A
dc.contributor.authorViana Baptista, P
dc.contributor.authorRamos Fernandes, A
dc.date.accessioned2019-02-22T11:51:41Z
dc.date.available2019-02-22T11:51:41Z
dc.date.issued2018
dc.description.abstractPhiladelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) represents the most common genetic subtype of adult ALL (20%-30%) and accounts for approximately 50% of all cases in the elderly. It has been considered the subgroup of ALL with the worst outcome. The introduction of tyrosine kinase inhibitors (TKIs) allows complete hematologic remission virtually in all patients, with improved disease-free survival and overall survival. Nevertheless, the emergence of resistant mutations in BCR-ABL1 may require different TKI strategies to overcome the patient's resistance and disease relapse. Here, we report a Ph+B-ALL case with persistent minimal residual disease (MRD) after treatment with dasatinib. The patient expressed the P190BCR-ABL1 isoform and a novel BCR-ABL1 mutation, p.Y440C. The latter is in the C-terminal lobe of the kinase domain, which likely induces deviations in the protein structure and activity and destabilizes its inactive conformation. The treatment was substituted by bosutinib, which binds to the active conformation of the protein, prior to allogeneic bone marrow transplant to overcome the lack of a complete response to dasatinib. These findings strengthen the importance of BCR-ABL1 mutational screening in Ph+ patients, particularly for those who do not achieve complete molecular remission.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationOnco Targets Ther. 2018 Nov 30;11:8589-8598.pt_PT
dc.identifier.doi10.2147/OTT.S177019pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3172
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherDove Medical Presspt_PT
dc.subjectHSAC HEMpt_PT
dc.subjectALLpt_PT
dc.subjectPhiladelphia Chromosomept_PT
dc.subjecte14a2pt_PT
dc.subjectMutationpt_PT
dc.subjectp.Y440Cpt_PT
dc.titleA Novel BCR-ABL1 Mutation in a Patient with Philadelphia Chromosome-Positive B-Cell Acute Lymphoblastic Leukemiapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage8598pt_PT
oaire.citation.startPage8589pt_PT
oaire.citation.titleOncoTargets and Therapypt_PT
oaire.citation.volume11pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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