FLT3-ITD POSITIVITY IN AML; CASE SERIES

Objective: Diagnosis of AML requires additional procedures, including pathological examination, immunophenotyping, cytogenetic examination, and molecular diagnosis. The determination of the specific cytogenetic abnormality is important for the selection of appropriate treatment and prognostic analys...

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Autor principal:	Kemal FİDAN
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Diseases of the blood and blood-forming organs RC633-647.5
Acceso en línea:	https://doaj.org/article/6a4381350ce843779a23299ee13d1329
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spelling	oai:doaj.org-article:6a4381350ce843779a23299ee13d13292021-11-10T04:35:07ZFLT3-ITD POSITIVITY IN AML; CASE SERIES2531-137910.1016/j.htct.2021.10.1020https://doaj.org/article/6a4381350ce843779a23299ee13d13292021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2531137921011676https://doaj.org/toc/2531-1379Objective: Diagnosis of AML requires additional procedures, including pathological examination, immunophenotyping, cytogenetic examination, and molecular diagnosis. The determination of the specific cytogenetic abnormality is important for the selection of appropriate treatment and prognostic analysis.The 2 most common mutations of the FLT3 gene are FLT3-ITD and FLT3-D835. Here, we will present FLT3-ITD positive AML cases admitted to our clinic between 2019-2021. Case report: We have 5 cases of AML FLT3-ITD heterozygous. In all our cases, Midastaurin was given with 7+3 chemotherapy (CT) in the initial treatment. While 1 of our cases went into remission, the other 4 relapsed. All of the patients who relapsed were given FLAG CT, no remission was achieved and they were switched to ADE CT. Remission was achieved in 2 of 4 patients, 2 of them were refractory. One patient was given gilteritinib. HSCT was performed in 2 patients. While 2 of our patients are dead, 2 of them are in remission and 1 of our patients is still under treatment. Results: FLT3 gene mutations are strongly associated with leukocytosis and poor prognosis in patients with AML(1-3). Patients with any of these mutations have a higher risk of recurrence and a lower survival rate3. All of our patients had leukocytosis at the time of diagnosis. Four of our patients relapsed and all of these patients were refractory to chemotherapy. Our patients who were refractory to treatment had a high mortality rate (50%) and a lower survival time (8-12 months). Conclusion: FLT3 signaling inhibitors have been used both alone and in combination to improve clinical outcomes in patients with AML with FLT3 mutations. While inhibitor monotherapy provides clinical response, its efficacy is usually temporary and resistance develops rapidly. Various combination therapies are used to enhance efficacy and prevent or overcome resistance. More studies are needed to evaluate its efficacy and explain the development of resistance.Kemal FİDANElsevierarticleDiseases of the blood and blood-forming organsRC633-647.5ENHematology, Transfusion and Cell Therapy, Vol 43, Iss , Pp S36-S37 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the blood and blood-forming organs RC633-647.5
spellingShingle	Diseases of the blood and blood-forming organs RC633-647.5 Kemal FİDAN FLT3-ITD POSITIVITY IN AML; CASE SERIES
description	Objective: Diagnosis of AML requires additional procedures, including pathological examination, immunophenotyping, cytogenetic examination, and molecular diagnosis. The determination of the specific cytogenetic abnormality is important for the selection of appropriate treatment and prognostic analysis.The 2 most common mutations of the FLT3 gene are FLT3-ITD and FLT3-D835. Here, we will present FLT3-ITD positive AML cases admitted to our clinic between 2019-2021. Case report: We have 5 cases of AML FLT3-ITD heterozygous. In all our cases, Midastaurin was given with 7+3 chemotherapy (CT) in the initial treatment. While 1 of our cases went into remission, the other 4 relapsed. All of the patients who relapsed were given FLAG CT, no remission was achieved and they were switched to ADE CT. Remission was achieved in 2 of 4 patients, 2 of them were refractory. One patient was given gilteritinib. HSCT was performed in 2 patients. While 2 of our patients are dead, 2 of them are in remission and 1 of our patients is still under treatment. Results: FLT3 gene mutations are strongly associated with leukocytosis and poor prognosis in patients with AML(1-3). Patients with any of these mutations have a higher risk of recurrence and a lower survival rate3. All of our patients had leukocytosis at the time of diagnosis. Four of our patients relapsed and all of these patients were refractory to chemotherapy. Our patients who were refractory to treatment had a high mortality rate (50%) and a lower survival time (8-12 months). Conclusion: FLT3 signaling inhibitors have been used both alone and in combination to improve clinical outcomes in patients with AML with FLT3 mutations. While inhibitor monotherapy provides clinical response, its efficacy is usually temporary and resistance develops rapidly. Various combination therapies are used to enhance efficacy and prevent or overcome resistance. More studies are needed to evaluate its efficacy and explain the development of resistance.
format	article
author	Kemal FİDAN
author_facet	Kemal FİDAN
author_sort	Kemal FİDAN
title	FLT3-ITD POSITIVITY IN AML; CASE SERIES
title_short	FLT3-ITD POSITIVITY IN AML; CASE SERIES
title_full	FLT3-ITD POSITIVITY IN AML; CASE SERIES
title_fullStr	FLT3-ITD POSITIVITY IN AML; CASE SERIES
title_full_unstemmed	FLT3-ITD POSITIVITY IN AML; CASE SERIES
title_sort	flt3-itd positivity in aml; case series
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/6a4381350ce843779a23299ee13d1329
work_keys_str_mv	AT kemalfidan flt3itdpositivityinamlcaseseries
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FLT3-ITD POSITIVITY IN AML; CASE SERIES

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