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Early T‐Cell Precursor Acute Lymphoblastic Leukemia in an Infant With an NRAS Q61R Mutation and Clinical Features of Juvenile Myelomonocytic Leukemia
Author(s) -
Raikar Sunil S.,
Scarborough John D.,
Sabnis Himalee,
Bergsagel John,
Wu David,
Cooper Todd M.,
Keller Frank G.,
Wood Brent L.,
Bunting Silvia T.
Publication year - 2016
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.26050
Subject(s) - juvenile myelomonocytic leukemia , medicine , neuroblastoma ras viral oncogene homolog , monocytosis , missense mutation , immunology , leukemia , mutation , transplantation , acute leukemia , cancer research , bone marrow , cancer , stem cell , genetics , haematopoiesis , biology , gene , colorectal cancer , kras
Early T‐cell precursor acute lymphoblastic leukemia (ETP‐ALL) is a subtype of T‐acute lymphoblastic leukemia (T‐ALL) arising from a primitive precursor. We present a unique case of an infant with ETP‐ALL with a missense NRAS mutation in codon 61 (c.182A>G, p.Q61R). The patient also had a minor population of non‐ETP T‐ALL blasts and clinical features typically associated with juvenile myelomonocytic leukemia (JMML), namely, absolute monocytosis, splenomegaly, and elevated hemoglobin F. The treatment was initiated with chemotherapy, followed by cord blood transplantation. The patient achieved remission, but unfortunately died from transplant‐related complications. This case highlights an NRAS mutation in ETP‐ALL with JMML‐like phenotype.