IL3-IGH fusion gene-positive pediatric acute lymphoblastic leukemia with hypereosinophilia as the first presentation: report of 1 case and review of literature
10.3760/cma.j.cn115356-20211231-00318
- VernacularTitle:以嗜酸粒细胞增多起病的IL3-IGH融合基因阳性儿童急性淋巴细胞白血病1例并文献复习
- Author:
Chunping WU
1
;
Zaisheng CHEN
;
Chunxia CAI
;
Yongzhi ZHENG
;
Shaohua LE
;
Jian LI
Author Information
1. 福建医科大学附属协和医院小儿血液科 福建省血液病研究所 福建省血液病学重点实验室，福州 350001
- Keywords:
Precursor cell lymphoblastic leukemia-lymphoma;
Child;
Eosinophilia;
Interleukin-3;
Immunoglobulin heavy chains;
Gene arrangement
- From:
Journal of Leukemia & Lymphoma
2022;31(8):484-487
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical characteristics and prognosis of IL3-IGH fusion gene-positive pediatric acute lymphoblastic leukemia (ALL) with hypereosinophilia as the first presentation.Methods:The clinical data of 1 pediatric IL3-IGH fusion gene-positive ALL patient with hypereosinophilia as the first presentation in January 2021 in Fujian Medical University Union Hospital was retrospectively analyzed and relevant literature was reviewed.Results:This 11-year-old male patient underwent bone marrow examination, and results showed that the proportion of eosinophils was increased; immunophenotyping disclosed that there were about 49.4% abnormal naive B lymphocytes in bone marrow; 43 leukemia fusion genes showed all negative; the whole transcriptome sequencing showed IL3-IGH fusion gene-positive. The patient was finally diagnosed as B-ALL with IL3-IGH fusion gene. According to the Chinese Children Cancer Group (CCCG)-ALL 2020 regimen, eosinophils returned to normal after induction therapy. Bone marrow examination on day 19 of induction showed that the proportion of promyelocytes was 0.005, the proportion of eosinophils was 0.05, and the minimal residual disease (MRD) was 23.02%. Bone marrow examination on day 46 of induction showed remission, and MRD was 0.18%. Consolidation chemotherapy used CAT (cyclophosphamide 1 g/m 2 once; cytarabine 50 mg/m 2, 12 h once, 7 days in total; mercaptopurine 40 mg/m 2, once per night, 7 days in total) regimen. Then the patient was added with lusotinib (75 mg 12 h once) orally and continued to receive high-dose methotrexate (5 g/m 2) regimen chemotherapy for 2 courses, the MRD was 0.20%. Chimeric antigen receptor T-cell (CAR-T) regimen was administered, followed by negative MRD. Conclusions:IL3-IGH fusion gene ALL is more frequently found in males, and more common in older children and young adults. It is prone to organ infiltration damage, and it has a high rate of induction failure and recurrence as well as poor prognosis.
