Evaluation of hypereosinophilia in a case of FLT3-mutant acute myeloid leukemia treated with gilteritinib

被引：1

作者：

Martinez-Gutierrez, Leslie N. ^{[1
]}

Burgher, Blake C. ^{[2
]}

Glynias, Manuel J. ^{[2
]}

Alvarado, Daniel ^{[1
]}

Griffiths, Elizabeth A. ^{[1
]}

Glenn, Sean T. ^{[2
]}

Sung, Pamela J. J. ^{[1
,3
]}

机构：

[1] Roswell Park Comprehens Canc Ctr, Dept Med, Buffalo, NY 14203 USA

[2] Roswell Park Comprehens Canc Ctr, Dept Pathol, Buffalo, NY 14203 USA

[3] Roswell Park Comprehens Canc Ctr, Dept Pharmacol & Therapeut, Buffalo, NY 14203 USA

来源：

COLD SPRING HARBOR MOLECULAR CASE STUDIES | 2023年 / 9卷 / 03期

关键词：

acute myeloid leukemia; eosinophilia; FLT3; DIFFERENTIATION; VENETOCLAX; MUTATIONS; CHEMOTHERAPY; COMBINATION; RESISTANCE; INHIBITOR; THERAPY;

D O I：

10.1101/mcs.a006279

中图分类号：

R-3 [医学研究方法]; R3 [基础医学];

学科分类号：

1001 ;

摘要：

Acute myeloid leukemias (AMLs) frequently harbor activating mutations in Fms-like tyrosine kinase 3 (FLT3). The use of FLT3 inhibitors (FLT3i) is the standard of care for treatment of newly diagnosed and relapsed patients with AML. Differentiation responses including clinical differentiation syndrome have been previously reported with FLT3i when used as single agents in relapsed disease. We present a case of hypereosinophilia in a patient on FLT3i therapy with persistent FLT3 polymerase chain reaction (PCR) positivity in peripheral blood. We sorted mature leukocytes by lineage to determine if the eosinophils were leukemia-derived. FLT3 PCR and next-generation sequencing analysis demonstrated monocytic differentiation of the FLT3-ITD leukemic clone with reactive hypereosinophilia that was derived from a preleukemic SF3B1, FLT3 wild-type clone. Our case is the first to definitively demonstrate the emergence of clonal FLT3-ITD monocytes with FLT3i and the first to demonstrate a differentiation response following decitabine, venetoclax, and gilteritinib triplet therapy.

引用

页数：14

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