Favorable response to dasatinib for extramedullary relapse after allogenic transplantation in a patient with NUP214-ABL1-positive B-cell precursor acute lymphoblastic leukemia

Abstract

Philadelphia chromosome (Ph)-like acute lymphoblastic leukemia (ALL) is a high-risk subtype characterized by a gene expression signature similar to that of Ph-positive ALL (Ph⁺ALL). The outcome for patients with Ph-like ALL may be improved by treatment with tyrosine kinase inhibitors; however, it is difficult to identify Ph-like ALL by conventional cytogenetic and molecular analyses. Here, we present the case of a female adolescent with B-cell precursor acute lymphoblastic leukemia (BCP-ALL) having a NUP214-ABL1 fusion, which was identified from the results of array comparative genomic hybridization (aCGH). She experienced extramedullary relapse after allogeneic HSCT, but achieved complete remission after receiving dasatinib. This suggests that tyrosine kinase inhibitors might be effective for Ph-like ALL with a NUP214-ABL1 fusion.