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Induction of Effector and Memory Cellular Immunity in a Patient with Long-Term Complete Molecular Response to Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia

Authors
  • Jo, Tatsuro
  • Shioya, Haruna
  • Tominaga, Hiroo
  • Sakai, Takahiro
  • Hayashi, Shizuka
  • Matsuzaka, Kaori
  • Kaneko, Yohei
  • Matsuo, Masatoshi
  • Taguchi, Jun
Type
Published Article
Journal
Case Reports in Oncology
Publisher
S. Karger AG
Publication Date
Aug 19, 2020
Volume
13
Issue
2
Pages
990–996
Identifiers
DOI: 10.1159/000508997
Source
Karger
Keywords
License
Green
External links

Abstract

This case report is about a patient who suffered from Philadelphia chromosome (Ph1)-positive acute lymphoblastic leukemia. The blasts were positive for myeloid-lineage markers including CD13 and CD33, as well as B-cell-lineage markers. Minor bcr-abl1 mRNA was detected by real-time quantitative polymerase chain reaction. Chromosomal abnormality monosomy 7 was also observed, in addition to Ph1. Despite treatment difficulties that were anticipated based on these findings, the patient had long-time complete molecular response (CMR) for approximately 5 years using chemotherapy and two tyrosine kinase inhibitors, imatinib and dasatinib. Lymphocytes were elevated after the patient switched from imatinib to dasatinib, and a T-cell receptor (TCR) V beta gene repertoire analysis revealed oligoclonal expansion of effector and memory cytotoxic T lymphocytes (CTLs), including Wilms tumor 1-specific CTLs. More specifically, the two memory CTLs expressing TCR V beta 3 and V beta 7.1 gradually increased after dasatinib administration. The activation and maintenance of anti-leukemia immunity may have allowed the patient to obtain long-time CMR. These results highlight that obtaining memory CTLs for leukemia cells may lead to safe withdrawal from dasatinib in the patient.

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