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阿伐替尼单药治疗可使经过大量治疗的KIT D816H突变的t(8;21)急性髓系白血病迅速且深度缓解:一例报告及文献综述

Avapritinib monotherapy induces rapid and deep remission of heavily treated, KIT D816H-mutated t(8;21) acute myeloid leukemia, a case report and literature review.

作者信息

Getz Ted M, Bakirhan Kamila, Seropian Stuart, Shallis Rory M

机构信息

Department of Internal Medicine, Section of Hematology, Yale University, New Haven, CT, USA.

Department of Hematology and Oncology, Danbury Hospital, Nuvance Health, Danbury, CT, USA.

出版信息

Ann Hematol. 2025 Jul;104(7):3889-3892. doi: 10.1007/s00277-025-06388-w. Epub 2025 Jun 27.

Abstract

Acute myeloid leukemia (AML) with t(8;21) is a subset of core binding factor AML and is considered to be favorable risk disease in patients receiving intensive cytarabine based chemotherapy. However, relapse remains a significant clinical challenge. Mutations in KIT, which frequently co-occur in t(8;21) AML, have been associated with worse relapse free and overall survival. Avapritinib is a novel tyrosine kinase inhibitor targeting KIT mutations that is approved for systemic mastocytosis but doesn't currently have an established role in the treatment of AML. We present a case of a patient with extensively treated KIT D816H-mutated t(8;21) AML who experienced relapse after an allogeneic hematopoietic stem cell transplant and achieved a deep remission rapidly with avapritinib monotherapy. This case highlights the potential role of avapritinib as a targeted therapy for relapsed t(8;21) AML with KIT mutations, warranting further clinical investigation.

摘要

伴有t(8;21)的急性髓系白血病(AML)是核心结合因子AML的一个亚型,在接受以阿糖胞苷为基础的强化化疗的患者中被认为是低风险疾病。然而,复发仍然是一个重大的临床挑战。KIT突变在t(8;21) AML中经常同时出现,与无复发生存期和总生存期较差有关。阿伐替尼是一种针对KIT突变的新型酪氨酸激酶抑制剂,已被批准用于系统性肥大细胞增多症,但目前在AML治疗中尚未确立其作用。我们报告一例经过广泛治疗的KIT D816H突变型t(8;21) AML患者,该患者在异基因造血干细胞移植后复发,接受阿伐替尼单药治疗后迅速实现深度缓解。该病例突出了阿伐替尼作为具有KIT突变的复发t(8;21) AML靶向治疗的潜在作用,值得进一步临床研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d94/12334448/f3883f5b81ff/277_2025_6388_Fig1_HTML.jpg

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