Successful bridge therapy of gilteritinib to cord blood transplantation in relapsed acute myeloid leukemia after bone marrow transplantation.

The FMS-related tyrosine kinase 3 (FLT3) internal tandem duplication mutations (FLT3-ITD) positive acute myeloid leukemia (AML) is a disease with a dismal outcome. Gilteritinib is a second-generation FLT3 inhibitor with activity against ITD and high affinity toward the FLT3 receptor, thereby showing therapeutic potential for relapsed/refractory FLT3-mutated AML. Bone marrow transplantation (BMT) from a human leukocyte antigen (HLA) identical sibling donor was performed in a 38-year-old Japanese male with FLT3-ITD positive AML. Neutrophil engraftment (>0.5 × 109/L) was achieved on day 16, and bone marrow remission was revealed on day 32. The patient's AML relapsed hematologically four months after BMT and was resistant to salvage chemotherapy. Gilteritinib was administered and the patient achieved non-remission but 'stable disease' status according to the response criteria. During administration, liver damage was observed but controllable. The patient received cord blood transplantation (CBT) as the second hematopoietic stem cell transplantation (HSCT) three months after relapse and achieved second remission. There was no evidence of recurrence of AML four months after CBT. This case demonstrates that gilteritinib can control FLT3-ITD positive AML that relapsed early after initial HSCT and can bridge to second HSCT.

Protective Effect of Selected Antioxidants on Naproxen Photodegradation in Aqueous Media.

A photostabilization strategy is an important aspect of quality assurance for photosensitive compounds. This study focused on the photoprotective effects of selected antioxidants including the effect of L-ascorbic acid (AA) on naproxen (NX) photodegradation in aqueous media. NX degradation during ultraviolet light (UV) irradiation and the protective effects of selected antioxidants were monitored by high-performance liquid chromatography (HPLC). The addition of AA induced the suppression of NX photodegradation, although the protective effect disappeared after AA was degraded completely. The results of the evaluations on the photoprotective effects on NX photodegradation and antioxidative activities of AA and other antioxidants showed that the protective effects of antioxidants are dependent on reducing power and photostability under UV irradiation. In this experiment, quercetin (QU) is the most effective antioxidant on account of the residual rate of QU after UV irradiation and the antioxidative activity in the potential antioxidant (PAO) test was significantly higher compared to other antioxidants following the higher protective effect on NX photodegradation.