Gilteritinib with or without venetoclax for relapsed/refractory FLT3-mutated acute myeloid leukaemia.

Patients with FLT3-mutated acute myeloid leukaemia (AML) that relapse or are refractory (R/R) to intensive induction have poor outcomes. Gilteritinib has recently become standard-of-care for patients with R/R FLT3-mutated AML. We investigated whether adding venetoclax to gilteritinib (gilt-ven) improves outcomes as compared with gilteritinib monotherapy. We included patients treated with gilteritinib (n = 19) and gilt-ven (n = 17) for R/R AML after intensive chemotherapy. Gilteritinib and gilt-ven groups did not differ in terms of mCRc rates (53% and 65%, p = 0.51) and realization of allogeneic haematopoietic stem-cell transplantation (HSCT, 47% and 35%, p = 0.5). Overall survival (OS) was comparable between groups, although a trend towards better OS was seen with gilt-ven (12-month OS 58.8% [95% CI 39.5%-87.6%]) versus gilteritinib (42.1% [95% CI 24.9%-71.3%] for gilteritinib). Early salvage with gilt-ven versus any other gilteritinib-based approach was associated with the best outcome (p = 0.031). Combination therapy was associated with increased haematological toxicity. In summary, gilt-ven did not improve remissions or HSCT-realization rates in patients with R/R FLT3-mutated AML as compared with gilteritinib and was associated with increased haematological toxicity. Although OS did not differ, a trend towards better survival was suggested with gilt-ven and a survival benefit was shown for gilt-ven approach when sequenced early for salvage.

Dimensional changes of the maxillary sinus following tooth extraction in the posterior maxilla with and without socket preservation.

BACKGROUND: Sinus pneumatization is commonly observed following tooth extraction in the posterior maxilla, however, the role of this pneumatization in the overall changes in the vertical bone height is not clear. PURPOSE: To compare dimensional changes in the alveolar ridge and corresponding maxillary sinus following tooth extraction, with or without socket preservation. MATERIALS AND METHODS: 42 patients underwent tooth extraction (control group) and 21 patients underwent tooth extraction with socket preservation using DBBM (study group). Panoramic radiographs, prior to and approximately 1 year post extractions were superimposed and matched using a fixed reference unit. The following measurements were performed in the midline of the tooth site: distance of the bone crest to the sinus floor; distance of the sinus floor to the sinus roof and the sagittal circumference of the maxillary. RESULTS: The mean change in the distance from the sinus floor to the sinus roof pre and post operatively was 0.30 mm (±0.10 SE) in the study group and 1.30 mm (±0.27 SE) in the control group (P = .0221). The mean change in the distance from the bone crest to the sinus floor was 0.32 mm (±0.09 SE) in the study group and 1.26 mm (±0.28 SE) in the control group (P = .0019), and the mean change in the sinus sagittal circumference was 37.34 mm (±6.10 SE) and 125.95 mm (±15.60 SE), respectively (P = .0001). CONCLUSIONS: Ridge preservation using bovine derived xenograft might reduce sinus pneumatization along with minimizing crestal bone resorption.