Case Report: Modified transplantation for a unilobed patient with chronic myeloid leukemia
Abstract
Although the use of tyrosine kinase inhibitors (TKI) for BCR::ABL in patients with chronic myeloid leukemia (CML) has significantly improved long -term life expectancy, the prognosis for patients with TKI resistance or for those who present with advanced disease is still dismal. As reported in numerous studies, the incidence of CML is higher in males than in females; however, the significant difference has not been observed with respect to age. CML consists of three clinical phases. The first stage is the chronic phase, and the second is accelerated phase, which usually lasts about 3 years; approximately 10% of cases in these two phases progress to the third phase (blastic phase). Allogeneic hematopoietic stem-cell transplantation remains the only curative option for patients with advanced CML. Here, we report a rare case of a 55-year-old female patient with CML who achieved successful outcomes following a lobectomy necessitated by a mucor infection. She experienced an early relapse in the central nervous system (CNS), and prompting a switch in treatment to a different TKI, intrathecal chemotherapy, craniospinal irradiation, and a combination regimen, including azacitidine, venetoclax and cytarabine. The patient presented with early-phase CNS-involved CML during TKI treatment, and subsequently received a transplant from a matched sibling donor using our modified conditioning regimen. This approach was appropriate for the patient. In this case of refractory and relapsed CML complicated by extramedullary involvement, particularly following pathological confirmation after pulmonary lobectomy, we adopted a modified conditioning regimen, which ultimately saved the patient’s life. This strategy serves as a reference for therapeutic approaches for future cases with extremely poor prognosis.
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BibTeX
@article{zhang2026case,
title = {{Case Report: Modified transplantation for a unilobed patient with chronic myeloid leukemia}},
author = {Danyang Zhang and Jiayue Qin and Juan Zhang and Na Chen and Jiaoyan Qu and Xiaolei Chen and Jie Li and Hongjia Huo and Yufei Song and Jie Wang and Hebing Zhou and Yan Yue},
journal = {Frontiers in Immunology},
year = {2026},
month = nov,
doi = {10.3389/fimmu.2026.1954192},
url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1954192},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Case Report: Modified transplantation for a unilobed patient with chronic myeloid leukemia
AU - Danyang Zhang
AU - Jiayue Qin
AU - Juan Zhang
AU - Na Chen
AU - Jiaoyan Qu
AU - Xiaolei Chen
AU - Jie Li
AU - Hongjia Huo
AU - Yufei Song
AU - Jie Wang
AU - Hebing Zhou
AU - Yan Yue
PY - 2026
DA - 2026/11/06
JO - Frontiers in Immunology
DO - 10.3389/fimmu.2026.1954192
UR - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1954192
AB - Although the use of tyrosine kinase inhibitors (TKI) for BCR::ABL in patients with chronic myeloid leukemia (CML) has significantly improved long -term life expectancy, the prognosis for patients with TKI resistance or for those who present with advanced disease is still dismal. As reported in numerous studies, the incidence of CML is higher in males than in females; however, the significant difference has not been observed with respect to age. CML consists of three clinical phases. The first stage is the chronic phase, and the second is accelerated phase, which usually lasts about 3 years; approximately 10% of cases in these two phases progress to the third phase (blastic phase). Allogeneic hematopoietic stem-cell transplantation remains the only curative option for patients with advanced CML. Here, we report a rare case of a 55-year-old female patient with CML who achieved successful outcomes following a lobectomy necessitated by a mucor infection. She experienced an early relapse in the central nervous system (CNS), and prompting a switch in treatment to a different TKI, intrathecal chemotherapy, craniospinal irradiation, and a combination regimen, including azacitidine, venetoclax and cytarabine. The patient presented with early-phase CNS-involved CML during TKI treatment, and subsequently received a transplant from a matched sibling donor using our modified conditioning regimen. This approach was appropriate for the patient. In this case of refractory and relapsed CML complicated by extramedullary involvement, particularly following pathological confirmation after pulmonary lobectomy, we adopted a modified conditioning regimen, which ultimately saved the patient’s life. This strategy serves as a reference for therapeutic approaches for future cases with extremely poor prognosis.
SN - 1664-3224
ER -