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Reduced intensity chemotherapy, tyrosine kinase inhibitor, and blinatumomab in a pediatric patient with Philadelphia chromosome-positive ALL and mechanical valves
  • +3
  • Richa Sharma,
  • Clifford Takemoto,
  • Benjamin Waller,
  • Ashley Holland,
  • Ching-Hon Pui,
  • Hiroto Inaba
Richa Sharma
Saint Jude Children's Research Hospital
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Clifford Takemoto
St. Jude Children’s Research Hospital
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Benjamin Waller
Le Bonheur Children's Hospital
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Ashley Holland
Saint Jude Children's Research Hospital
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Ching-Hon Pui
St. Jude Children's Research Hospital
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Hiroto Inaba
St. Jude Children's Research Hospital
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Abstract

The outcome of pediatric patients with Philadelphia chromosome (Ph)-positive acute lymphoid leukemia (ALL) has improved with addition of tyrosine kinase inhibitors to an intense chemotherapy. However, it is associated with high incidences of adverse effects and requires new therapeutic strategies for maximum anti-leukemic effect and reduced toxicities. We describe a challenging adolescent case with Ph-positive ALL and mechanical mitral and aortic valves due to Shone’s syndrome. The patient received reduced intensity chemotherapy and blinatumomab with dasatinib and is in deep molecular remission. Long-term anticoagulation was achieved with enoxaparin for mechanical valves and unfractionated heparin during procedures.

Peer review status:Published

28 Jan 2021Published in Pediatric Blood & Cancer. 10.1002/pbc.28924