Recurrent finding of the FIP1L1-PDGFRA fusion gene in eosinophilia-associated acute myeloid leukemia and lymphoblastic T-cell lymphoma

Leukemia. 2007 Jun;21(6):1183-8. doi: 10.1038/sj.leu.2404662. Epub 2007 Mar 22.

Abstract

The FIP1L1-PDGFRA fusion gene has been described in patients with eosinophilia-associated myeloproliferative disorders (Eos-MPD). Here, we report on seven FIP1L1-PDGFRA-positive patients who presented with acute myeloid leukemia (AML, n=5) or lymphoblastic T-cell non-Hodgkin-lymphoma (n=2) in conjunction with AML or Eos-MPD. All patients were male, the median age was 58 years (range, 40-66). AML patients were negative for common mutations of FLT3, NRAS, NPM1, KIT, MLL and JAK2; one patient revealed a splice mutation of RUNX1 exon 7. Patients were treated with imatinib (100 mg, n=5; 400 mg, n=2) either as monotherapy (n=2), as maintenance treatment after intensive chemotherapy (n=3) or in overt relapse 43 and 72 months, respectively, after primary diagnosis and treatment of FIP1L1-PDGFRA-positive disease (n=2). All patients are alive, disease-free and in complete hematologic and complete molecular remission after a median time of 20 months (range, 9-36) on imatinib. The median time to achievement of complete molecular remission was 6 months (range, 1-14). We conclude that all eosinophilia-associated hematological malignancies should be screened for the presence of the FIP1L1-PDGFRA fusion gene as they are excellent candidates for treatment with tyrosine kinase inhibitors even if they present with an aggressive phenotype such as AML.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Benzamides
  • Disease-Free Survival
  • Eosinophilia / complications
  • Eosinophilia / drug therapy*
  • Humans
  • Imatinib Mesylate
  • Leukemia, Myeloid / drug therapy*
  • Male
  • Middle Aged
  • Myeloproliferative Disorders / drug therapy
  • Nucleophosmin
  • Oncogene Proteins, Fusion / analysis*
  • Oncogene Proteins, Fusion / genetics
  • Piperazines / administration & dosage*
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy*
  • Protein-Tyrosine Kinases / antagonists & inhibitors
  • Pyrimidines / administration & dosage*
  • Receptor, Platelet-Derived Growth Factor alpha* / genetics
  • Remission Induction / methods
  • mRNA Cleavage and Polyadenylation Factors* / genetics

Substances

  • Benzamides
  • FIP1L1 protein, human
  • NPM1 protein, human
  • Oncogene Proteins, Fusion
  • Piperazines
  • Pyrimidines
  • mRNA Cleavage and Polyadenylation Factors
  • Nucleophosmin
  • Imatinib Mesylate
  • Protein-Tyrosine Kinases
  • Receptor, Platelet-Derived Growth Factor alpha