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Case Reports
. 2022 Apr 22:15:393-407.
doi: 10.2147/PGPM.S346688. eCollection 2022.

Therapeutic Management of Patients with FLT3 + Acute Myeloid Leukemia: Case Reports and Focus on Gilteritinib Monotherapy

Monica Bocchia  1 , Angelo Michele Carella  2 , Antonino Mulè  3 , Lorenzo Rizzo  4 , Mauro Turrini  5 , Maria Chiara Abbenante  2 , Roberto Cairoli  4 , Valeria Calafiore  3 , Marzia Defina  1 , Angelo Gardellini  5 , Giovanni Luzi  6 , Caterina Patti  3 , Maria Beatrice Pinazzi  6 , Marta Riva  4 , Giovanni Rossi  2 , Vincenzo Sammartano  1 , Luigi Rigacci  6
Affiliations
Case Reports

Therapeutic Management of Patients with FLT3 + Acute Myeloid Leukemia: Case Reports and Focus on Gilteritinib Monotherapy

Monica Bocchia et al. Pharmgenomics Pers Med. .

Abstract

Acute myeloid leukemia is a malignant disorder of the bone marrow, characterized by differentiation, clonal expansion, and uncontrolled proliferation of malignant myeloid progenitor cells and by several molecular and genetic abnormalities. A mutation of FMS-like tyrosine kinase 3 gene can be observed in about one-third of cases of acute myeloid leukemia. Two FLT3 inhibitors are actually approved for FLT3 mutated acute myeloid leukemia: midostaurin, a multikinase first generation inhibitor with lower affinity for FLT3 binding, and gilteritinib fumarate, a potent second-generation inhibitor of both FLT3-ITD and TKD. Gilteritinib is a new effective and well-tolerated drug for patients with relapsing or refractory FLT3-positive acute myeloid leukemia. Thanks to its efficacy, low toxicity, its good manageability (oral formulation), this drug is suitable for all the patients, including elderly frail patient with concomitant therapies or pre-existing or underlying diseases, and can be used also in the outpatient setting, reducing risks and costs related to the hospitalization. We report and discuss seven cases of different patients with FLT3 positive acute myeloid leukemia successfully managed with gilteritinib in the real clinical practice.

Keywords: FLT3; acute myeloid leukemia; gilteritinib; midostaurin.

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Conflict of interest statement

Dr Lorenzo Rizzo reports personal fees from Editree Srl, during the conduct of the study. The authors reports no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Molecular biology clearance.
Figure 2
Figure 2
Haematological recovery.
Figure 3
Figure 3
Consolidating pneumonia before starting gilteritinib.
Figure 4
Figure 4
Evolution of the skin rash during the differentiation syndrome (A-F).
Figure 5
Figure 5
CT scans of submandibular and laterocervical sarcoma.
Figure 6
Figure 6
Evolution of the cutaneous sarcoma in a submandibular abscess.
Figure 7
Figure 7
Evolution of the myeloid sarcoma during the treatment with gilteritinib.
Figure 8
Figure 8
NPM1/FLT3-ITD assays.
See this image and copyright information in PMC

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