Wang J, Zu Y L, Gui R R, Li Z, Zhang Yanli, Zhou J
Department of Hematology, Henan Cancer Hospital, the Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China.
Zhonghua Xue Ye Xue Za Zhi. 2024 Aug 14;45(8):761-766. doi: 10.3760/cma.j.cn121090-20240129-00043.
To investigate the efficacy and safety of avapritinib in the treatment of molecular biologically positive core binding factor-acute myeloid leukemia (CBF-AML) with KIT mutation after allogeneic hematopoietic stem cell transplantation (allo-HSCT) . We retrospectively analyzed the clinical data of six patients with molecular biologically positive CBF-AML with KIT mutation after allo-HSCT, who were treated with avapritinib at Henan Cancer Hospital from December 2021 to March 2023, and evaluated the efficacy and safety of avapritinib. After 1 month of treatment with avapritinib, the transcription level of the fusion gene decreased in six patients, and the transcription level decreased by ≥1 log in five patients. In four patients who received avapritinib for ≥3 months, the fusion gene turned negative, and the median time to turn negative was 2.0 (range: 1.0-3.0) months. Up to the end of follow-up, four patients had no recurrence. The most common adverse reaction of avapritinib was myelosuppression, including neutropenia in two cases, thrombocytopenia in two cases, and anemia in one case. The non-hematological adverse reactions were nausea in two cases, edema in one case, and memory loss in one case, all of which were grades 1-2. Avapritinib was effective for molecular biologically positive CBF-AML patients with KIT mutation after allo-HSCT. The main adverse reaction was myelosuppression, which could generally be tolerated.
探讨阿伐替尼治疗异基因造血干细胞移植(allo-HSCT)后分子生物学阳性且伴有KIT突变的核心结合因子急性髓系白血病(CBF-AML)的疗效和安全性。我们回顾性分析了2021年12月至2023年3月在河南省肿瘤医院接受阿伐替尼治疗的6例allo-HSCT后分子生物学阳性且伴有KIT突变的CBF-AML患者的临床资料,并评估阿伐替尼的疗效和安全性。阿伐替尼治疗1个月后,6例患者融合基因转录水平下降,5例患者转录水平下降≥1 log。在接受阿伐替尼治疗≥3个月的4例患者中,融合基因转阴,转阴的中位时间为2.0(范围:1.0 - 3.0)个月。至随访结束时,4例患者无复发。阿伐替尼最常见的不良反应是骨髓抑制,包括2例中性粒细胞减少、2例血小板减少和1例贫血。非血液学不良反应为2例恶心、1例水肿和1例记忆力减退,均为1 - 2级。阿伐替尼对allo-HSCT后分子生物学阳性且伴有KIT突变的CBF-AML患者有效。主要不良反应是骨髓抑制,一般可耐受。