Use of midostaurin in mixed phenotype acute leukemia with FLT3 mutation: A case series

Mixed phenotype acute leukemia (MPAL) is a rare type of acute leukemia where blasts present phenotypes from more than one lineage. A poor prognostic has been associated with this disease, and limited data are currently available to guide the choice of therapy. Regarding FLT3‐positive MPAL, only one...

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Bibliographic Details
Published in:European journal of haematology 2022-02, Vol.108 (2), p.163-165
Main Authors: Tremblay, Zoë, Wong, Anna, Otis, Anne‐Sophie, Pépin, Marie‐Anne, Bambace, Nadia, Soulières, Denis, Bouchard, Philippe, Adam, Jean‐Philippe
Format: Article
Language:English
Subjects:
Adult
Aged
Antineoplastic Agents - administration & dosage
Antineoplastic Agents - adverse effects
Antineoplastic Agents - therapeutic use
Biomarkers, Tumor
Cell Lineage - genetics
Chemotherapy
Female
FLT3 inhibitor
fms-Like Tyrosine Kinase 3
Humans
Leukemia
Leukemia, Biphenotypic, Acute - diagnosis
Leukemia, Biphenotypic, Acute - drug therapy
Leukemia, Biphenotypic, Acute - genetics
Male
Middle Aged
midostaurin
mixed phenotype acute leukemia
Molecular Targeted Therapy
Mutation
Patients
Phenotype
Phenotypes
Protein Kinase Inhibitors - administration & dosage
Protein Kinase Inhibitors - adverse effects
Protein Kinase Inhibitors - therapeutic use
Remission
Remission (Medicine)
Staurosporine - administration & dosage
Staurosporine - adverse effects
Staurosporine - analogs & derivatives
Staurosporine - therapeutic use
Stem cell transplantation
Treatment Outcome
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Description
Summary:Mixed phenotype acute leukemia (MPAL) is a rare type of acute leukemia where blasts present phenotypes from more than one lineage. A poor prognostic has been associated with this disease, and limited data are currently available to guide the choice of therapy. Regarding FLT3‐positive MPAL, only one case treated with midostaurin has been published to date. Here, we report the successful use of midostaurin to treat three FLT3‐positive MPAL T/myeloid and B/myeloid patients. Midostaurin was successfully added to intensive induction (two patients) and consolidation chemotherapy (three patients) without significant adverse events requiring a dose adjustment or discontinuation. The therapy received resulted in complete remission for two patients and complete remission with an incomplete hematologic recovery for the third. All patients proceeded to HSCT and stayed in remission after an extended follow‐up respectively at 28, 31, and 11 months later. These results suggest that the addition of midostaurin during induction and consolidation therapy may represent a treatment option for FLT3‐positive MPAL.
ISSN:0902-4441
1600-0609
DOI:10.1111/ejh.13717