Journal
CUREUS JOURNAL OF MEDICAL SCIENCE
Volume 13, Issue 9, Pages -Publisher
SPRINGERNATURE
DOI: 10.7759/cureus.18368
Keywords
bcr-abl; tyrosine kinase receptor inhibitors; imatinib; blast crisis; rt-qpcr; chronic myeloid leukemia (cml)
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Sudden blast crisis in CML patients being treated with TKIs is uncommon but significant. Improving drug selection and careful monitoring can help prevent such unfortunate outcomes.
Sudden blast crisis is an uncommon phenomenon in chronic myeloid leukemia (CML) patients who are being treated with tyrosine kinase inhibitors (TKIs). Despite well-defined guidelines to treat and monitor the disease, it is difficult to predict the occurrence of a sudden blast crisis. Research directed towards improving guidelines in choosing the appropriate TKIs and better monitoring protocols could help prevent such unfortunate outcomes. We present a case of a 46-year-old man diagnosed with CML who responded well to imatinib as evidenced by a downtrend in quantitative BCR-ABL mutation to less than 1. He quickly transformed into a blast crisis phase after five months of therapy with imatinib regardless of achieving an excellent initial optimal response. In conclusion, it is possible to transform into a blast phase despite achieving an initial optimal response. Therefore, attention should be focused on the selection of proper tyrosine kinase inhibitors and careful monitoring to allow the early detection of sudden blast crisis.
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