論文

国際誌
2021年12月

Myelomonocytic differentiation of leukemic blasts accompanied by differentiation syndrome in a case of FLT3-ITD-positive AML treated with gilteritinib.

Hematology (Amsterdam, Netherlands)
  • Takeshi Kondo
  • ,
  • Masahiro Onozawa
  • ,
  • Shinichi Fujisawa
  • ,
  • Shinpei Harada
  • ,
  • Reiki Ogasawara
  • ,
  • Koh Izumiyama
  • ,
  • Makoto Saito
  • ,
  • Masanobu Morioka
  • ,
  • Akio Mori
  • ,
  • Takanori Teshima

26
1
開始ページ
256
終了ページ
260
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1080/16078454.2021.1889111

Fms-like tyrosine kinase 3 (FLT3) is one of the most frequently mutated genes in acute myelogenous leukemia (AML) and the mutation is associated with poor prognosis of patients. Two distinct types of activating mutations have been identified in AML samples. One is internal tandem duplications in the juxtamembrane domain (FLT3-ITD) and the other is point mutations in the tyrosine kinase domain (FLT3-TKD). Gilteritinib is a FLT3 inhibitor that inhibits both FLT3-ITD and FLT3-TKD. It was reported that differentiation of leukemic blasts accompanied by differentiation syndrome occurs in some patients treated with gilteritinib. However, information about the precise clinical course is limited, and appropriate management of differentiation syndrome has not been established. We report a case of relapsed AML with FLT3-ITD that was treated with gilteritinib. Analysis of the FLT3-ITD variant allele frequency (VAF) revealed that FLT3-ITD VAF was not decreased despite achievement of complete remission with incomplete hematologic recovery. Remarkable increases of monocytes and granulocytes accompanied by differentiation syndrome were observed at 6 months after the initiation of gilteritinib treatment. Intermittent chemotherapy with low-dose cytarabine and mitoxantrone was effective for reducing myelomonocytosis and resolving differentiation syndrome.

リンク情報
DOI
https://doi.org/10.1080/16078454.2021.1889111
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/33631087
ID情報
  • DOI : 10.1080/16078454.2021.1889111
  • PubMed ID : 33631087

エクスポート
BibTeX RIS