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Annals of Hematology

, Volume 98, Issue 12, pp 2841–2843 | Cite as

Acute myeloid leukemia with a cryptic NUP98/PRRX2 rearrangement developing after low-dose methotrexate therapy for rheumatoid arthritis

  • Kazuhisa ChonabayashiEmail author
  • Yoshinori Yoshida
  • Toshio Kitawaki
  • Yasuhito Nannya
  • Momoko Nakamura
  • Shinichiro Oshima
  • Masakatsu Hishizawa
  • Kouhei Yamashita
  • Seishi Ogawa
  • Akifumi Takaori-Kondo
Letter to the Editor

Dear Editor,

NUP98 is known to be fused to at least 31 different partner genes in both de novo and therapy-related leukemia [1]. Chromosomal translocations juxtaposing the class II homeobox gene PRRX2 with NUP98 loci have been reported in therapy-related acute myeloid leukemia (AML), but their clinical significance is unclear [2, 3]. Here, we report a case of AML harboring a cryptic NUP98/PRRX2 translocation following low-dose methotrexate (MTX) therapy for rheumatoid arthritis.

A 72-year-old Japanese woman presented with anemia, thrombocytopenia, elevated WBC counts, and the appearance of blasts in the peripheral blood. The patient had been diagnosed with rheumatoid arthritis and was subsequently treated with low-dose MTX. The duration of the MTX therapy was 221 months and the accumulated dose was approximately 5000 mg. Bone marrow examination disclosed 55.6% blasts, most of which were positive for myeloperoxidase and specific esterase; the immunophenotype was CD13 +, CD33 +, MPO +, and...

Notes

Funding information

This work was supported by grants from the Project for Cancer Research and Therapeutic Evolution (P-CREATE) (19cm0106235h0002) and the Acceleration Program for Intractable Diseases Research utilizing Disease-specific iPS cells (19bm0804004h0003) of the Japan Agency for Medical Research and Development.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was obtained from the patient included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Kazuhisa Chonabayashi
    • 1
    • 2
    Email author
  • Yoshinori Yoshida
    • 2
  • Toshio Kitawaki
    • 1
  • Yasuhito Nannya
    • 3
  • Momoko Nakamura
    • 1
  • Shinichiro Oshima
    • 1
  • Masakatsu Hishizawa
    • 1
  • Kouhei Yamashita
    • 1
  • Seishi Ogawa
    • 3
  • Akifumi Takaori-Kondo
    • 1
  1. 1.Department of Hematology and Oncology, Graduate School of MedicineKyoto UniversityKyotoJapan
  2. 2.Department of Cell Growth and Differentiation, Center for iPS Cell Research and ApplicationKyoto UniversityKyotoJapan
  3. 3.Department of Pathology and Tumor Biology, Graduate School of MedicineKyoto UniversityKyotoJapan

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