Isolated central nervous system blast crisis in chronic myeloid leukemia under treatment with dasatinib. A case report and literature review

Isolated central nervous system blast crisis in chronic myeloid leukemia under treatment with dasatinib. A case report and literature review

Autores/as

  • Humberto Martínez-Cordero El Bosque University, Bogotá, D.C., Colombia
  • Roberto Ramos-Córdoba Hematology and Bone Marrow Transplantation Unit, National Cancer Institute, Bogotá, D.C., Colombia
  • Rafael Gaitán-Aroca Hematology and Bone Marrow Transplantation Unit, National Cancer Institute, Bogotá, D.C., Colombia
  • Andrea García-B. Hematology and Bone Marrow Transplantation Unit, National Cancer Institute, Bogotá, D.C., Colombia
  • Sandra Chinchilla Hematopathology Department, National Cancer Institute, Bogotá, D.C., Colombia
  • Giovana Bedón Hematopathology Department, National Cancer Institute, Bogotá, D.C., Colombia
  • Isabella Novoa-Caicedo El Bosque University, Bogotá, D.C., Colombia

DOI:

https://doi.org/10.35509/01239015.836

Palabras clave:

blast crisis, chronic myeloid leukemia, central nervous system

Resumen

Chronic myeloid leukemia (CML) is a disease that occurs in three phases: chronic, accelerated, and blast crisis. Blast crisis is diagnosed when there are 20% or more blasts in the bone marrow or extramedullary blast infiltration, frequently in the form of myeloid sarcoma. Isolated central nervous system blast crisis is very rare and even more in patients treated with dasatinib, which has good penetrance at this level. We present the case of a 61-year-old patient with a long-term diagnosis of CML under treatment with dasatinib, maintaining a major molecular response, who consulted for headaches and seizures, ruling out anatomical and infectious causes. CSF analysis showed the presence of blasts with a normal bone marrow biopsy, which led to the diagnosis of isolated central nervous system blast crisis. Dasatinib treatment continued at a higher dose, and an intrathecal chemotherapy regimen with Ommaya reservoir was established, with excellent results. Isolated central nervous system blast crisis is rare; most cases have been reported under treatment with imatinib, which has low penetrance at this level. There is only one case in the literature of blast crisis treated with dasatinib, and it has lymphoid origin. Management is not well established due to limited literature on the subject. Multicenter studies are required to delineate an adequate treatment in this case type.

Referencias bibliográficas

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Cómo citar

[1]
Martínez-Cordero, H., Ramos-Córdoba, R., Gaitán-Aroca, R., García-Buitrago , A., Chinchilla, S., Bedón, G. y Novoa-Caicedo, I. 2022. Isolated central nervous system blast crisis in chronic myeloid leukemia under treatment with dasatinib. A case report and literature review: Isolated central nervous system blast crisis in chronic myeloid leukemia under treatment with dasatinib. A case report and literature review. Revista Colombiana de Cancerología. 26, 4 (dic. 2022), 448–52. DOI:https://doi.org/10.35509/01239015.836.

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Publicado

2022-12-30

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Reportes de caso