p190(BCR-ABL) rearrangement as a secondary change in a case of acute myelo-monocytic leukemia with inv(16)(p13q22).

The simultaneous occurrence of two specific primary chromosomal changes in hematological malignancies is rare. We report on a patient with acute myelo-monocytic leukemia and both inv(16)(p13q22) and t(9;22)(q34;q11) with a p190(BCR-ABL) rearrangement. The t(9;22)(q34;q11) translocation appears to be a secondary change. Similar secondary BCR-ABL rearrangements have already been described and, in most cases, the chimeric protein was of the p190(BCR-ABL) type as in our case. A complete remission was obtained by conventional chemotherapy followed with imatinib mesylate maintenance therapy. At relapse, the BCR-ABL transcripts were undetectable, which suggests that imatinib mesylate could be an effective adjuvant treatment in acute leukemia with a secondary t(9;22)(q34;q11).