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Burkitt leukemia with precursor B-cell features that developed after ruxolitinib treatment in a patient with hydroxyurea-refractory JAK2V617F-myeloproliferative neoplasm.


ABSTRACT: A 62-year-old woman, who had a 16-year history of JAK2V617F-mutated myeloproliferative neoplasm (MPN), developed Burkitt leukemia (BL) 16 months after treatment with ruxolitinib to control hydroxyurea-refractory conditions. BL cells were CD10+, CD19+, CD20-, CD34-, cytoplasmic CD79a+, and TdT+, and lacked surface immunoglobulins but expressed the cytoplasmic μ heavy chain. In the bone marrow, nuclear MYC+ BL cells displaced the MPN tissues. t(8;14)(q24;q32) occurred at a CG dinucleotide within MYC exon 1 and at the IGHJ3 segment, and an N-like segment was inserted at the junction. The V-D-J sequence of the non-translocated IGH allele had the unmutated configuration. DNA from peripheral blood at a time of the course of MPN exhibited homozygous JAK2V617F mutation, while that at BL development included both JAK2V617F and wild-type DNAs. Although the association between JAK1/2 inhibitor therapy for MPN and secondary development of aggressive B-cell neoplasm remains controversial, this report suggests that, in selected patients, close monitoring of clonal B-cells in the BM is required before and during treatment with JAK1/2 inhibitors.

SUBMITTER: Fukutsuka K 

PROVIDER: S-EPMC8265492 | biostudies-literature | 2021 Jun

REPOSITORIES: biostudies-literature

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Burkitt leukemia with precursor B-cell features that developed after ruxolitinib treatment in a patient with hydroxyurea-refractory JAK2<sup>V617F</sup>-myeloproliferative neoplasm.

Fukutsuka Katsuhiro K   Iioka Futoshi F   Maekawa Fumiyo F   Nakagawa Miho M   Kishimori Chiyuki C   Hayashida Masahiko M   Tagawa Shunsuke S   Akasaka Takashi T   Honjo Gen G   Ohno Hitoshi H  

Journal of clinical and experimental hematopathology : JCEH 20210514 2


A 62-year-old woman, who had a 16-year history of JAK2<sup>V617F</sup>-mutated myeloproliferative neoplasm (MPN), developed Burkitt leukemia (BL) 16 months after treatment with ruxolitinib to control hydroxyurea-refractory conditions. BL cells were CD10<sup>+</sup>, CD19<sup>+</sup>, CD20<sup>-</sup>, CD34<sup>-</sup>, cytoplasmic CD79a<sup>+</sup>, and TdT<sup>+</sup>, and lacked surface immunoglobulins but expressed the cytoplasmic μ heavy chain. In the bone marrow, nuclear MYC<sup>+</sup> BL  ...[more]

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