Effective treatment with Gilteritinib-based regimens for FLT3-mutant extramedullary relapse in acute promyelocytic leukemia
Chun-xiao Hou,
Yu Chen,
Shan-hao Liu,
Yi-zhi Jiang,
Dong-ping Huang,
Su-ning Chen
Affiliations
Chun-xiao Hou
National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou, People’s Republic of China
Yu Chen
Department of Hematology, the Second Affiliated Hospital of Wannan Medical College, Wuhu, People’s Republic of China
Shan-hao Liu
Department of Hematology, the First Affiliated Hospital of Wannan Medical College, Wuhu, People’s Republic of China
Yi-zhi Jiang
Department of Hematology, the First Affiliated Hospital of Wannan Medical College, Wuhu, People’s Republic of China
Dong-ping Huang
Department of Hematology, the First Affiliated Hospital of Wannan Medical College, Wuhu, People’s Republic of China
Su-ning Chen
National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Soochow University, Suzhou, People’s Republic of China
Objective: Extramedullary relapse (EMR) is rare in acute promyelocytic leukemia (APL) and, there is a lack of information on its management. Current practices for EMR in APL are always to adopt strategies from other subtypes of Acute lymphoblastic leukemia (ALL) and Acute myeloid leukemia (AML). Gilteritinib, a highly selective FLT3 inhibitor, has demonstrated a remarkable effect on EMR in FLT3-mutant AML. Therefore, it is worthwhile exploring if FLT3 mutation can be a therapeutic target and assessing the efficacy of Gilteritinib on FLT3-mutant EMR in APL.Methods: We described three cases of FLT3-mutant EMR in APL, comprising two isolated EMR cases and one systemic relapse. The patients underwent treatment with Gilteritinib-based regimens based on FLT3 mutation.Results: All three patients achieved complete regression of EMR, and no signs of tumor lysis syndrome during Gilteritinib-based therapy, only patient 1 showed mild granulocytopenia. They all maintained molecular complete remission (mCR) during the follow-up period.Conclusions: The Gilteritinib-based regimen shows a high and sustained therapeutic effect with minimal adverse effects, and provides a valuable experience for further evaluation in EMR APL patients.
