scholarly journals Very Early Onset of Therapy-Related Acute Myeloid Leukemia with 11q23 Rearrangement Presenting with Unusual PET Findings after R-DA-EPOCH for Primary Mediastinal Large B-Cell Lymphoma

Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 48
Author(s):  
Chrysovalantou Chatzidimitriou ◽  
Phivi Rondogianni ◽  
Maria Arapaki ◽  
Athanasios Liaskas ◽  
Eleni Plata ◽  
...  

Background: R-DA-EPOCH is an effective regimen for PMLBCL, which permits the omission of consolidative radiotherapy in the majority of patients. Patient: We describe a 27-year-old female patient, who achieved a complete remission after treatment with six cycles of R-DA-EPOCH (up to the final level). At 6 months after the end of treatment, PET/CT revealed an unexpected, diffusely increased 18FDG uptake by the bone marrow. Simultaneously, pancytopenia with monocytosis was observed. Result: The patient was diagnosed with therapy-related myelodysplastic syndrome, which rapidly evolved into acute myeloid leukemia (t-MDS/AML) with MLL rearrangements. She achieved a complete remission after induction therapy, received an allogenic transplant and remains disease-free 2 years later. Conclusions: The extremely early onset of t-MDS/AML, together with the unexpected PET/CT findings make this case unique and highlights the need for the accurate estimation of the possible dose-dependent risk of t-MDS/AML after R-DA-EPOCH in the real-life setting in patients with PMLBCL.

2003 ◽  
Vol 4 (3) ◽  
pp. 218-221 ◽  
Author(s):  
Felicetto Ferrara ◽  
Ettore Mariano Schiavone ◽  
Salvatore Palmieri ◽  
Giuseppina Mele ◽  
Barbara Pocali ◽  
...  

2021 ◽  
pp. 1-6
Author(s):  
Megan Othus ◽  
Guillermo Garcia-Manero ◽  
John Godwin ◽  
James Weick ◽  
Derek Stirewalt ◽  
...  

Author(s):  
Aliihsan Gemici ◽  
Fahir Ozkalemkas ◽  
Mehmet Hilmi Dogu ◽  
Atakan Tekinalp ◽  
Inci Alacacioglu ◽  
...  

Leukemia ◽  
2013 ◽  
Vol 28 (3) ◽  
pp. 713-716 ◽  
Author(s):  
V Vainstein ◽  
S A Buckley ◽  
O Shukron ◽  
E H Estey ◽  
J L Abkowitz ◽  
...  

2010 ◽  
Vol 28 (11) ◽  
pp. 1856-1862 ◽  
Author(s):  
Farhad Ravandi ◽  
Jorge E. Cortes ◽  
Daniel Jones ◽  
Stefan Faderl ◽  
Guillermo Garcia-Manero ◽  
...  

Purpose To determine the efficacy and toxicity of the combination of sorafenib, cytarabine, and idarubicin in patients with acute myeloid leukemia (AML) younger than age 65 years. Patients and Methods In the phase I part of the study, 10 patients with relapsed AML were treated with escalating doses of sorafenib with chemotherapy to establish the feasibility of the combination. We then treated 51 patients (median age, 53 years; range, 18 to 65 years) who had previously untreated AML with cytarabine at 1.5 g/m2 by continuous intravenous (IV) infusion daily for 4 days (3 days if > 60 years of age), idarubicin at 12 mg/m2 IV daily for 3 days, and sorafenib at 400 mg orally twice daily for 7 days. Results Overall, 38 (75%) patients have achieved a complete remission (CR), including 14 (93%) of 15 patients with mutated FMS-like tyrosine kinase-3 (FLT3; the 15th patient had complete remission with incomplete platelet recovery [CRp]) and 24 (66%) of 36 patients with FLT3 wild-type (WT) disease (three additional FLT3-WT patients had CRp). FLT3-mutated patients were more likely to achieve a CR than FLT3-WT patients (P = .033). With a median follow-up of 54 weeks (range, 8 to 87 weeks), the probability of survival at 1 year is 74%. Among the FLT3-mutated patients, 10 have relapsed and five remain in CR with a median follow-up of 62 weeks (range, 10 to 76 weeks). Plasma inhibitory assay demonstrated an on-target effect on FLT3 kinase activity. Conclusion Sorafenib can be safely combined with chemotherapy, produces a high CR rate in FLT3-mutated patients, and inhibits FLT3 signaling.


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