From the observation of atypical cells on blood smear to the diagnosis of mast cell leukemia: a case report in a 79 year old woman consulting for anemia.
Fiche publication
Date publication
décembre 2017
Journal
Annales de biologie clinique
Auteurs
Membres identifiés du Cancéropôle Est :
Dr LESESVE Jean-François
Tous les auteurs :
Decker J, Meyer S, Latger-Cannard V, Visanica S, Loppinet E, Lesesve JF, Bénet B
Lien Pubmed
Résumé
Mast cell leukemia is an extremely rare disease, which belongs to the systemic mastocytosis group (WHO 2016). We are reporting the case of a 79-year-old woman, without any hematological particular history consulting for hyperthermia, repeated malaise and subacute anemia. Her clinical examination was normal. Unusual cells were seen on blood and bone marrow smears. They represent more than 10% of blood nucleated cells end more than 20% of the bone marrow nucleated cells. Bone marrow immunophenotyping was performed to characterize these cells. It revealed a cell subset expressing the surface antigens CD117, CD2 and CD25. This immunophenotypic profile is the hallmark of malignant mast cells. Then mast cell leukemia diagnosis could have been made and KIT gene sequencing highlighted the N822Y mutation in exon 17. The patient was initially treated with midostaurin, a tyrosine kinase inhibitor. Lack of therapeutic response and absence of the KIT D816V mutation led to switch to imatinib, following the latest scientific recommendations.
Mots clés
D816V mutation, KIT, atypical mast cells, mast cell leukemia, midostaurin
Référence
Ann. Biol. Clin. (Paris). 2017 Dec 1;75(6):689-694