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Durable remission of post-transplant relapsed FLT3-ITD AML in response to gilteritinib administration after a second transplant from the same donor.
Ando, Toshihiko; Sano, Haruna; Yokoo, Masako; Kusaba, Kana; Kidoguchi, Keisuke; Yamaguchi, Kyosuke; Katsuya, Hiroo; Yoshihara, Satoshi; Kubota, Yasushi; Kojima, Kensuke; Kimura, Shinya.
Afiliação
  • Ando T; Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan. ando1013@cc.saga-u.ac.jp.
  • Sano H; Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
  • Yokoo M; Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
  • Kusaba K; Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
  • Kidoguchi K; Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
  • Yamaguchi K; Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
  • Katsuya H; Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
  • Yoshihara S; Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
  • Kubota Y; Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
  • Kojima K; Department of Transfusion Medicine, Saga University Hospital, Saga, Japan.
  • Kimura S; Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
Int J Hematol ; 112(2): 249-253, 2020 Aug.
Article em En | MEDLINE | ID: mdl-32185622
ABSTRACT
Patients with FMS-like tyrosine kinase 3 internal tandem duplication (FLT3-ITD) acute myeloid leukemia (AML) respond to conventional induction chemotherapy, with remission rates similar to those seen in other subtypes; however, they are much more likely to relapse and relapse is rapid. For this reason, eligible patients receive consolidation therapy with early allogenic transplantation, but the recurrence rate remains high, even after transplantation. Moreover, the optimal therapy for patients with FLT3-ITD AML who relapse after allogeneic hematopoietic stem cell transplantation remains unclear. Here, we report a case in which graft-versus-leukemia (GVL) effects were induced by gilteritinib administration after a second transplant from the same donor, resulting in sustained remission of early FLT3-ITD AML relapse after allogeneic transplantation. Several studies suggest that the benefits of FLT3 tyrosine kinase inhibitors (FLT3-TKI) after allogeneic transplantation are attributable to GVL induction, as well as direct effects on FLT3 mutation-positive leukemia cells. With this in mind, we induced lymphodepletion using L-PAM to further enhance GVL induction by donor lymphocytes and FLT3-TKI. We believe that enhancement of GVL induction by lymphodepletion should be considered before FLT3-TKI use, if the prognosis is very poor, such as in patients with recurrence following allogeneic transplantation.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Pirazinas / Recidiva / Doadores de Tecidos / Leucemia Mieloide Aguda / Transplante de Células-Tronco Hematopoéticas / Sequências de Repetição em Tandem / Tirosina Quinase 3 Semelhante a fms / Compostos de Anilina Tipo de estudo: Prognostic_studies Limite: Female / Humans Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Pirazinas / Recidiva / Doadores de Tecidos / Leucemia Mieloide Aguda / Transplante de Células-Tronco Hematopoéticas / Sequências de Repetição em Tandem / Tirosina Quinase 3 Semelhante a fms / Compostos de Anilina Tipo de estudo: Prognostic_studies Limite: Female / Humans Idioma: En Ano de publicação: 2020 Tipo de documento: Article