The Clinical Relevance of Detection of BCR-ABL in an Asymptomatic Patient: A Case Report and Review of the Literature - Abstract
Chronic myelogenous leukemia is associated with the hallmark BCR-ABL translocation. With the increase in sensitivity in methods detecting the BCR/ ABL copy number, a small percentage of healthy subjects have been found to harbor low levels of the Philadelphia chromosome without evidence of chronic myelogenous leukemia. We present a case of a 71 year old male who was incidentally found to have a BCR/ABL chromosomal translocation on bone marrow biopsy being completed for a marginal zone lymphoma. The patient had no hematologic abnormalities on complete blood count when the BCR/ABL translocation was detected. The patient was treated with imatinib and developed a major molecular response. Currently no data exists on what percentage of healthy subjects that harbor low levels of the Philadelphia chromosome will go on to develop CML. These patients pose a clinical dilemma with regards to if they should be treated and when treatment should be initiated.