Abstract 276P
Background
Lymphadenpathy is a very unusual manifestation of CML-CP with an unclear implication on prognosis. We sought to understand the occurrence of this phenomenon and its effect on prognosis in newly diagnosed cases of CML-CP at a tertiary cancer centre in South India.
Methods
A retrospective analysis of all the newly diagnosed cases of CML-CP between January 2016 and December 2018 was undertaken and patients presenting with lymphadenopathy were identified. Data pertaining to CML diagnosis, work up and their clinical outcomes were recorded. Descriptive statistics were used.
Results
Four cases of CML-CP presenting with lymphadenopathy were identified out of 143 cases recorded in this time period (2.8%). The age range is 7-44 years (mean = 25 years) for these cases. All these cases were diagnosed on basis of peripheral smear and bone marrow picture consistent with CML-CP and RT-PCR for BCR-ABL positive for e13a2 (p210). Lymphadenopathy was cervical alone in one case and generalized in the rest of the cases. FNAC of lymph nodes at baseline were suggestive of reactive lymphadenitis. Two out of 4 patients (50%) were high risk according to EUTOS score. All the patients (irrespective of risk group) were started on Imatinib 400mg qDay (250mg/m2 for the paediatric patient). All the four patients progressed to blast crisis, 3 of them being lymphoid blast crisis (75%). The mean time to progression was 14.5 months (range 6-23 months). In contrast, only 1 patient in the rest of 139 patient cohort developed blast crisis in the three years data. ABL kinase domain mutation analysis was done in all the four patients, 2 of them showed Imatinib resistant mutations with both of them more sensitive to Dasatinib. Karyotype at the time of progression to blast crisis was done in 2 patients and it showed isochromosome 17p in one patient.Table1: 276P
Clinical features and key investigation of patients of CML-CP presenting with lymphadenopathy
Age/sex | EUTOS risk | time to progression (months) | ABL KD mutation | Karyotype |
---|---|---|---|---|
7/F | High | 6 | not detected | Iso17p |
18/M | Low | 12 | Not detected | Not done |
32/M | Low | 14 | M244V | Not done |
44/M | High | 23 | Y235H | Normal |
Conclusions
Lymphadenopathy at diagnosis of CML-CP has a very poor prognosis and heralds early progression to blast crisis.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Gedala Veni Prasanna.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
4P - Impact of chemotherapy and radiotherapy on tissue expander or implant removal in breast cancer patients
Presenter: Sungmi Jung
Session: Poster display session
Resources:
Abstract
5P - Long-term prognostic effect of hormone receptor subtype on breast cancer
Presenter: Ki-tae Hwang
Session: Poster display session
Resources:
Abstract
6P - Effect of apparent diffusion coefficient in predicting pathologic responses in patients with breast cancer treated with neoadjuvant chemotherapy using nanoparticle albumin-bound paclitaxel
Presenter: Yutaka Mizuno
Session: Poster display session
Resources:
Abstract
7P - Current diagnostic strategy for mammographic microcalcification without specific ultrasound abnormality
Presenter: Naoki Sato
Session: Poster display session
Resources:
Abstract
8P - Comparison of standard uptake value of 18F-FDG-PET-CT with tumour-infiltrating lymphocytes in breast cancer ≥1cm
Presenter: Soeun Park
Session: Poster display session
Resources:
Abstract
10P - Prognosis and effect of adjuvant treatment in small, node(-), HER2(+) breast cancer
Presenter: Seungtaek Lim
Session: Poster display session
Resources:
Abstract
11P - The prognosis of rare histopathologic subtype of breast cancer
Presenter: Soo Youn Bae
Session: Poster display session
Resources:
Abstract
12P - Daily collection of physical activity via smartphone application and smart band for development of distress screening tools in breast cancer survivors: A feasibility study
Presenter: Yungil Shin
Session: Poster display session
Resources:
Abstract
13P - Breast cancer distribution in East Azerbaijan, Iran: Results of population-based cancer registry
Presenter: Shima Pashaei
Session: Poster display session
Resources:
Abstract
14P - Validation of the optimum timing of assessment of tumour infiltrating lymphocytes during preoperative chemotherapy for breast cancer
Presenter: Shinichiro Kashiwagi
Session: Poster display session
Resources:
Abstract