Iannotta R, Celentano M, Marotta S, Pedata C M, Riccardi C, Migliaccio I, Viola A, Muggianu S M, Falco C, Bovenzi D, Ferrara F, Picardi A
Stem Cell Transplant Program, AORN Cardarelli, Naples, Italy.
Hematology, AORN Cardarelli, Naples, Italy.
Leuk Res Rep. 2022 Jul 27;18:100340. doi: 10.1016/j.lrr.2022.100340. eCollection 2022.
Case of a patient with acute myeloid leukemia (AML) positive for mutations in both genes NPM1 and FLT3-ITD who underwent two allogeneic haematopoietic stem cell transplants (HSCT); the second allograft one was followed by extramedullary relapse (granulocytic sarcoma of right breast), with blast cells positive for FLT3-ITDmutation. Treatment with Gilteritinib, a second generation selective oral type I FLT3 inhibitor, was started after the second HSCT with complete regression of breast granulocytic sarcoma in absence of hematological and extra hematologic toxicity. We conclude that Gilteritinib can represent an effective therapy for extra hematologic relapse, with acceptable toxicity and outpatient management.
一名急性髓系白血病（AML）患者，其NPM1和FLT3-ITD基因均发生突变，接受了两次异基因造血干细胞移植（HSCT）；第二次同种异体移植后出现髓外复发（右乳粒细胞肉瘤），原始细胞FLT3-ITD突变呈阳性。第二代选择性口服I型FLT3抑制剂吉瑞替尼在第二次HSCT后开始使用，乳腺粒细胞肉瘤完全消退，且无血液学和血液外毒性。我们得出结论，吉瑞替尼可作为血液外复发的有效治疗方法，毒性可接受且可门诊管理。
