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Sustained remission with azacitidine monotherapy and an aberrant precursor B-lymphoblast population in juvenile myelomonocytic leukemia.


ABSTRACT: Juvenile myelomonocytic leukemia (JMML) has a poor prognosis in general, with hematopoietic stem cell transplant (HSCT) remaining the standard of care for cure. The hypomethylating agent, azacitidine, has been used as a bridging therapy to transplant. However, no patients have been treated with azacitidine without an HSCT post azacitidine. We report on an infant with JMML with somatic KRAS G12A mutation and monosomy 7 who achieved sustained remission following azacitidine monotherapy. He also developed an aberrant B-lymphoblast population which declined with similar kinetics as his JMML-associated abnormalities, suggesting that a B-lymphoblast population in JMML does not always progress to acute leukemia.

SUBMITTER: Hashmi SK 

PROVIDER: S-EPMC7328527 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Sustained remission with azacitidine monotherapy and an aberrant precursor B-lymphoblast population in juvenile myelomonocytic leukemia.

Hashmi Saman K SK   Punia Jyotinder N JN   Marcogliese Andrea N AN   Gaikwad Amos S AS   Fisher Kevin E KE   Roy Angshumoy A   Rao Pulivarthi P   Lopez-Terrada Dolores H DH   Ringrose Jo J   Loh Mignon L ML   Niemeyer Charlotte M CM   Rau Rachel E RE  

Pediatric blood & cancer 20190628 10


Juvenile myelomonocytic leukemia (JMML) has a poor prognosis in general, with hematopoietic stem cell transplant (HSCT) remaining the standard of care for cure. The hypomethylating agent, azacitidine, has been used as a bridging therapy to transplant. However, no patients have been treated with azacitidine without an HSCT post azacitidine. We report on an infant with JMML with somatic KRAS G12A mutation and monosomy 7 who achieved sustained remission following azacitidine monotherapy. He also de  ...[more]

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