Coexistence of BCR-ABL1 Translocation and JAK2 V617F Mutation in a Patient with Chronic Myeloid Leukemia Under Long-term Treatment with Imatinib and Nilotinib: A Case Report

 This report describes an 89-year-old woman diagnosed with Philadelphia positive Chronic Myeloid Leukemia in 2007 who was initially treated with 200 mg/day imatinib. The patient demonstrated complete molecular response (CMR) in two tests in 2015 and 2018. During treatment between 2007 and 2019, despite increased dosage of imatinib and switching her therapy to nilotinib, complete hematological response was not obtained. ARMS-PCR was performed to find the possible cause of this failed response and JAK2 V617F mutation was detected. The patient with no BCR/ABL1 transcript showed a relatively good molecular response to nilotinib, although the complete hematological response was not observed. According to our findings, tyrosine kinase inhibitor could not be an effective therapy in this JAK2 V617F-positive MPN patient with a BCR/ABL1 mutation.