Open Access

Acute pro‑B‑Cell lymphoblastic leukemia transformed from myelodysplastic syndrome with an ASXL1 missense mutation: A case report with literature review

  • Authors:
    • Zhi‑Ping Guo
    • Yan‑Hong Tan
    • Jian‑Lan Li
    • Zhi‑Fang Xu
    • Xiu‑Hua Chen
    • Lian‑Rong Xu
  • View Affiliations

  • Published online on: April 20, 2018     https://doi.org/10.3892/ol.2018.8546
  • Pages: 9745-9750
  • Copyright: © Guo et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The development of acute lymphoblastic leukemia (ALL) from myelodysplastic syndrome (MDS) is a very rare event. The current report presents a rare case of a 33‑year‑old man who was diagnosed with MDS with multiple‑lineage dysplasia (MDS‑MLD) that transformed into pro‑B‑ALL. A missense mutation (S1231F) of the additional sex combs like 1, transcriptional regulator gene was identified, which may have a substantial role in the progression, however does not act as an unfavorable prognostic marker. The patient died during induction chemotherapy. The present study further conducted an analysis on 30 patients to determine progression to ALL. Patients were predominantly male (76.7%, 23/30) with a median age of 56 years (3‑90 years). The median time to transformation was 5.5 months (2‑50 months). The most common type of MDS with ALL transformation comprised of MDS‑excess blasts (MDS‑EB; 40%, 12/30), MDS with single‑lineage dysplasia (MDS‑SLD; 30%, 9/30) and MDS with ring sideroblasts (MDS‑RS; 16.7%, 5/30). The majority of the patients transformed to B‑cell (66.7%, 16/24) followed by T‑cell (33.3%, 8/24) ALL. From the 25 cases where data was available, the complete remission rate was 75% (15/20) with ALL‑directed chemotherapy and the median remission duration was 15 months (range 4.5 to 51 months). However, the results indicated that ALL following MDS is characterized by a high rate of early death (20%, 5/25).
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June-2018
Volume 15 Issue 6

Print ISSN: 1792-1074
Online ISSN:1792-1082

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Spandidos Publications style
Guo ZP, Tan YH, Li JL, Xu ZF, Chen XH and Xu LR: Acute pro‑B‑Cell lymphoblastic leukemia transformed from myelodysplastic syndrome with an ASXL1 missense mutation: A case report with literature review. Oncol Lett 15: 9745-9750, 2018.
APA
Guo, Z., Tan, Y., Li, J., Xu, Z., Chen, X., & Xu, L. (2018). Acute pro‑B‑Cell lymphoblastic leukemia transformed from myelodysplastic syndrome with an ASXL1 missense mutation: A case report with literature review. Oncology Letters, 15, 9745-9750. https://doi.org/10.3892/ol.2018.8546
MLA
Guo, Z., Tan, Y., Li, J., Xu, Z., Chen, X., Xu, L."Acute pro‑B‑Cell lymphoblastic leukemia transformed from myelodysplastic syndrome with an ASXL1 missense mutation: A case report with literature review". Oncology Letters 15.6 (2018): 9745-9750.
Chicago
Guo, Z., Tan, Y., Li, J., Xu, Z., Chen, X., Xu, L."Acute pro‑B‑Cell lymphoblastic leukemia transformed from myelodysplastic syndrome with an ASXL1 missense mutation: A case report with literature review". Oncology Letters 15, no. 6 (2018): 9745-9750. https://doi.org/10.3892/ol.2018.8546