Approximately 10% of Ph-Like patients have ABL class gene fusions, which include the FIP1L1::PDGFRA rearrangement. We report a case of a pediatric patient with Ph-like B-lymphoblastic leukemia (B-LL) with a FIP1L1::PDGFRA fusion and their treatment course using a combination of chemotherapy and targeted therapy with imatinib. A 10-year-old female presented with lethargy, palpitations, and fevers. She had pancytopenia, no eosinophilia, and flow cytometry consistent with B-LL. FISH identified a CHIC2 deletion, suggestive of FIP1L1::PDGFRA fusion, confirmed on next-generation RNA sequencing. The patient commenced targeted therapy with imatinib, which she continued until completion of standard chemotherapy per COG AALL1732. She remains in remission 6 months post-completion of therapy. B-ALL with a FIP1L1::PDGFRA fusion is extremely rare, particularly in pediatrics. FIP1L1::PDGFRA rearrangements can be difficult to detect on routine testing and may not always be seen in association with eosinophilia. Identification of FIP1L1::PDGFRA rearrangements is important as they enable treatment with a tyrosine kinase inhibitor, which has significantly improved the overall prognosis for PDGFRA-rearranged neoplasms. Prospective studies assessing imatinib dosage, duration, and long-term safety are warranted in this cohort.
{"title":"FIP1L1::PDGFRA Fusion in a Pediatric Patient Presenting With B-Cell Lymphoblastic Leukemia","authors":"Jenna Nunn, Bronwyn Williams, David Deambrosis","doi":"10.1002/gcc.70037","DOIUrl":"https://doi.org/10.1002/gcc.70037","url":null,"abstract":"<p>Approximately 10% of Ph-Like patients have <i>ABL</i> class gene fusions, which include the <i>FIP1L1::PDGFRA</i> rearrangement. We report a case of a pediatric patient with Ph-like B-lymphoblastic leukemia (B-LL) with a <i>FIP1L1::PDGFRA</i> fusion and their treatment course using a combination of chemotherapy and targeted therapy with imatinib. A 10-year-old female presented with lethargy, palpitations, and fevers. She had pancytopenia, no eosinophilia, and flow cytometry consistent with B-LL. FISH identified a <i>CHIC2</i> deletion, suggestive of <i>FIP1L1::PDGFRA</i> fusion, confirmed on next-generation RNA sequencing. The patient commenced targeted therapy with imatinib, which she continued until completion of standard chemotherapy per COG AALL1732. She remains in remission 6 months post-completion of therapy. B-ALL with a <i>FIP1L1::PDGFRA</i> fusion is extremely rare, particularly in pediatrics. <i>FIP1L1::PDGFRA</i> rearrangements can be difficult to detect on routine testing and may not always be seen in association with eosinophilia. Identification of <i>FIP1L1::PDGFRA</i> rearrangements is important as they enable treatment with a tyrosine kinase inhibitor, which has significantly improved the overall prognosis for <i>PDGFRA</i>-rearranged neoplasms. Prospective studies assessing imatinib dosage, duration, and long-term safety are warranted in this cohort.</p>","PeriodicalId":12700,"journal":{"name":"Genes, Chromosomes & Cancer","volume":"64 2","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/gcc.70037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}