Abstract
Sir, We report a patient with Philadelphia-positive acute lymphoblastic leukemia (ALL) (Ph + ALL) who failed to respond to first-line tyrosine kinase inhibitors (TKIs) and was subsequently detected to have T315I mutation in the BCR-ABL kinase domain. Qualitative reverse transcriptase polymerase chain reaction (RT-PCR) revealed a minor translocation in BCR-ABL involving exons e2' (bcr) and e2 (abl) resulting in a 190 kD fusion protein. Even though HLA-matched allogeneic stem cell transplants are currently standard of care in Ph + ALL, even alternate donor or haploidentical transplants may be justified in situ ations where resistant mutations are identified and are likely to work better if instituted before the onset of morphological relapse.
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Details
1 Department of Medical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu