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- Title
Evolution of T-cell clonality in a patient with Ph-negative acute lymphocytic leukemia occurring after interferon and imatinib therapy for Ph-positive chronic myeloid leukemia.
- Authors
Liang Wang; Zhu, Kanger; Xianfeng Zha; Shaohua Chen; Lijian Yang; Si Chen; Yangqiu Li
- Abstract
Introduction: The development of Philadelphia chromosome (Ph) negative acute leukemia/myelodysplastic syndrome (MDS) in patients with Ph-positive chronic myeloid leukemia (CML) is very rare. The features of restrictive usage and absence of partial T cell clones have been found in patients with CML. However, the T-cell clonal evolution of Ph-negative malignancies during treatment for CML is still unknown. Objective: To investigate the dynamic change of clonal proliferation of T cell receptor (TCR) Vα and Vβ subfamilies in one CML patient who developed Ph-negative acute lymphoblastic leukemia (ALL) after interferon and imatinib therapy. Methods: The peripheral blood mononuclear cells (PBMC) samples were collected at the 3 time points (diagnosis of Ph-positive chronic phase (CP) CML, developing Ph-negative ALL and post inductive chemotherapy (CT) for Ph-negative ALL, respectively). The CDR3 size of TCR Vα and Vβ repertoire were detected by RT-PCR. The PCR products were further analyzed by genescan to identify T cell clonality. Results: The CML patient who achieved complete cytogenetic remission (CCR) after 5 years of IFN-a therapy suddenly developed Ph-negative ALL 6 months following switch to imatinib therapy. The expression pattern and clonality of TCR Vα/Vβ T cells changed in different disease stages. The restrictive expression of Vα/Vβ subfamilies could be found in all three stages, and partial subfamily of T cells showed clonal proliferation. Additionally, there have been obvious differences in Vα/Vβ subfamily of T cells between the stages of Ph-positive CML-CP and Ph-negative ALL. The Vα10 and Vβ3 T cells evolved from oligoclonality to polyclonality, the Vβ13 T cells changed from bioclonality to polyclonality, when Ph-negative ALL developed. Conclusions: Restrictive usage and clonal proliferation of different Vα/Vβ subfamily T cells between the stages of Ph-positive CP and Ph-negative ALL were detected in one patient. These changes may play a role in Ph- negative leukemogenesis.
- Subjects
LYMPHOBLASTIC leukemia; LYMPHOCYTIC leukemia; IMATINIB; ANTINEOPLASTIC agents; PROTEIN-tyrosine kinase inhibitors; MYELODYSPLASTIC syndromes; BONE marrow diseases; DYSPLASIA; CANCER chemotherapy
- Publication
Journal of Hematology & Oncology, 2010, Vol 3, p14
- ISSN
1756-8722
- Publication type
Article
- DOI
10.1186/1756-8722-3-14