A Relapsing Meningeal Acute Myeloid Leukaemia FLT3-ITD+ Responding to Gilteritinib

Chemotherapy ◽  
2021 ◽  
pp. 1-5
Author(s):  
Salvatore Perrone ◽  
Elettra Ortu La Barbera ◽  
Federica Viola ◽  
Elena Cipollone ◽  
Maria Cristina Scerpa ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Acute Myeloid Leukaemia ◽  
Myeloid Leukaemia ◽  
Residual Disease ◽  
Complete Response ◽  
Myeloid Sarcoma ◽  
Leg Pain ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Acute Myeloid

A patient with a therapy-related acute myeloid leukaemia (AML), NPM1<sup>mut</sup>, and FLT3-ITD+ was treated with induction and consolidation with CPX-351, obtaining a complete response (CR) but minimal residual disease persisted positive. Later, she complained progressive burning leg pain, weakening of the right hand and leg muscles, associated with absence of osteotendinous leg reflexes. Examination of cerebrospinal fluid (CSF) showed a meningeal relapse of AML. Moreover, a magnetic resonance imaging (MRI) showed 2 right meningeal implants of myeloid sarcoma and bone marrow revealed haematologic relapse of disease. She was treated with medicated lumbar punctures (LPs) followed by an FLA-Ida scheme, and she achieved a 2nd CR. Unfortunately, the patient developed hyperleucocytosis and reappearance of meningeal myeloid sarcoma at MRI. For this reason, a monotherapy with gilteritinib (an FLT3 inhibitor) was started: after 3 months of therapy, central nervous system (CNS)-disease shrunken and then faded, while AML in the bone marrow achieved only a partial response. This is the 1st report of a positive biological effect of gilteritinib on CNS (meningeal) myeloid sarcoma. There are no studies of gilteritinib concentration into CSF and penetration of gilteritinib into the blood-brain barrier should be further studied, given the paucity of drugs active on CNS relapse of AML. In patients receiving CPX-351 only, diagnostic LP should be considered after induction.

scholarly journals Acute myeloid leukaemia relapse presenting as cardiac myeloid sarcoma

2018 ◽  
pp. bcr-2018-224419
Author(s):  
Alexander Waselewski ◽  
Michael Joiner ◽  
Steven Raymond Miller
Keyword(s):  
Acute Myeloid Leukaemia ◽  
Myeloid Leukaemia ◽  
Right Atrium ◽  
Residual Disease ◽  
Vena Cava ◽  
Myeloid Sarcoma ◽  
Adjuvant Radiation ◽  
History Of ◽  
The Right ◽  
Acute Myeloid

A 50-year-old woman previously diagnosed with acute myeloid leukaemia presented with a 3-month history of shortness of breath and a right-sided facial rash. A chest CT revealed an intracardiac mass in the right atrium extending into her superior and inferior vena cava. Surgery was performed to remove the mass and pathology was consistent with myeloid sarcoma. After surgery, adjuvant radiation therapy was directed to the residual disease. The patient eventually relapsed in other sites not including the right atrium and eventually succumbed to her disease.

Wilms tumour gene 1 overexpression in bone marrow as a marker for minimal residual disease in acute myeloid leukaemia

2008 ◽  
Vol 80 (3) ◽  
pp. 201-207 ◽  
Author(s):  
Mauri M. Hämäläinen ◽  
Veli Kairisto ◽  
Vesa Juvonen ◽  
Janita Johansson ◽  
Jukka Aurén ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Acute Myeloid Leukaemia ◽  
Myeloid Leukaemia ◽  
Minimal Residual Disease ◽  
Residual Disease ◽  
Wilms Tumour ◽  
Minimal Residual ◽  
Acute Myeloid

scholarly journals CD34+CD38-CD123+ Cells Are Present in Virtually All Acute Myeloid Leukaemia Blasts: A Promising Single Unique Phenotype for Minimal Residual Disease Detection

2017 ◽  
Vol 138 (3) ◽  
pp. 175-181 ◽  
Author(s):  
Adhra Al-Mawali ◽  
Avinash Daniel Pinto ◽  
Shoaib Al-Zadjali
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Acute Myeloid Leukaemia ◽  
Myeloid Leukaemia ◽  
Minimal Residual Disease ◽  
De Novo ◽  
Residual Disease ◽  
Intention To Treat ◽  
Minimal Residual ◽  
Acute Myeloid

Background/Aims: In CD34-positive acute myeloid leukaemia (AML), the leukaemia-initiating event likely takes place in the CD34+CD38- cell compartment. CD123 has been shown to be a unique marker of leukaemic stem cells within the CD34+CD38- compartment. The aim of this study was to identify the percentage of CD34+CD38-CD123+ cells in AML blasts, AML CD34+CD38- stem cells, and normal and regenerating bone marrow CD34+CD38- stem cells from non-myeloid malignancies. Methods: Thirty-eight adult de novo AML patients with intention to treat were enrolled after the application of inclusion criteria from February 2012 to February 2017. The percentage of the CD34+CD38-CD123+ phenotype in the blast population at diagnosis was determined using a CD45-gating strategy and CD34+ backgating by flow cytometry. We studied the CD34+CD38-CD123+ fraction in AML blasts at diagnosis, and its utility as a unique phenotype for minimal residual disease (MRD) of AML patients. Results: CD123+ cells were present in 97% of AML blasts in patients at diagnosis (median 90%; range 21-99%). CD123+ cells were also present in 97% of the CD34+CD38- compartment (median 0.8164%, range 0.0262-39.7%). Interestingly, CD123 was not present in normal and regenerating CD34+CD38- bone marrow stem cells (range 0.002- 0.067 and 0.004-0.086, respectively). Conclusion: The CD34+CD38-CD123+ phenotype is present in virtually all AML blasts and it may be used as a unique single phenotype for MRD detection in AML patients.

Bone marrow mononuclear cell telomere length in acute myeloid leukaemia and high‐risk myelodysplastic syndrome

2019 ◽  
Vol 102 (3) ◽  
pp. 218-226
Author(s):  
Marie Warny ◽  
Jens Helby ◽  
Henrik Sengeløv ◽  
Børge G. Nordestgaard ◽  
Henrik Birgens ◽  
...  
Keyword(s):  
Bone Marrow ◽  
High Risk ◽  
Acute Myeloid Leukaemia ◽  
Myelodysplastic Syndrome ◽  
Myeloid Leukaemia ◽  
Telomere Length ◽  
Mononuclear Cell ◽  
Bone Marrow Mononuclear Cell ◽  
Acute Myeloid
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