Lei Y T, Zhao X L, Hong M, Liu W J, Sun Q, Qian S X, Wang S, Zhu Y
Department of Hematology, Jiangsu Province Hospital, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Zhonghua Xue Ye Xue Za Zhi. 2024 Dec 14;45(12):1129-1133. doi: 10.3760/cma.j.cn121090-20240615-00224.
This study aimed to assess the efficacy and safety of gilteritinib combined with chemotherapy in treating newly diagnosed FLT3-mutated acute myeloid leukemia (AML). We retrospectively collected clinical data from 16 patients newly diagnosed with FLT3-mutated AML at Jiangsu Province Hospital. Patients received induction therapy with the classic "3 + 7" regimen or the VA regimen, and all patients were immediately supplied with gilteritinib after detecting FLT3-ITD/TKD mutations. Of the 16 patients, 12 were male and 4 were female, with a median age of 52.5 years (range: 15-76 years). Additionally, 15 patients had FLT3-ITD mutations and 1 had FLT3-TKD mutation. The complete remission (CR/CRi) rate was 93.8% (15/16) after the first cycle of gilteritinib-based induction therapy, with 13 patients achieving MRD negativity detected with flow cytometry. All patients achieved a CR(MRD-) during the consolidation phase. FLT3 mutation clearance was achieved among all 14 patients who underwent next-generation sequencing (NGS) analysis. The 12-month overall survival and relapse-free survival rates were both 73.9%, respectively, with a median followup of 18 months. Nine (56.2%) patients experienced infectious fever during the induction therapy. Three patients had grade 3 QTc prolongation during consolidation and maintenance therapy. Treatment-related adverse events were generally tolerable.
本研究旨在评估吉瑞替尼联合化疗治疗新诊断的FLT3突变型急性髓系白血病（AML）的疗效和安全性。我们回顾性收集了江苏省人民医院16例新诊断的FLT3突变型AML患者的临床资料。患者接受经典的“3 + 7”方案或VA方案诱导治疗，所有患者在检测到FLT3-ITD/TKD突变后立即给予吉瑞替尼。16例患者中，男性12例，女性4例，中位年龄52.5岁（范围：15 - 76岁）。此外，15例患者有FLT3-ITD突变，1例有FLT3-TKD突变。基于吉瑞替尼的诱导治疗第一个周期后，完全缓解（CR/CRi）率为93.8%（15/16），13例患者通过流式细胞术检测达到微小残留病阴性。所有患者在巩固期均达到CR（MRD-）。接受下一代测序（NGS）分析的14例患者均实现了FLT3突变清除。12个月总生存率和无复发生存率分别为73.9%，中位随访时间为18个月。9例（56.2%）患者在诱导治疗期间出现感染性发热。3例患者在巩固和维持治疗期间出现3级QTc延长。治疗相关不良事件一般可耐受。
