Abstract
We describe a case of acute myeloid leukemia with NPM1 mutation and disseminated leukemia cutis in a very old patient, who achieved a long-lasting response to the azacitidine/venetoclax combination with molecular complete remission, given the potential value of this rarely observed clinical outcome.
References
1.
Osmola M, Gierej B, Kłosowicz A, Waszczuk-Gajda A, Basak GW, Jędrzejczak WW, et al. Leukaemia cutis for clinicians, a literature review. Postepy Dermatol Alergol. 2021 Jun;38(3):359–65.
2.
Scaramucci L, Niscola P, Fratoni S, Giovannini M, Cupelli L, Tendas A, et al. Multicentric myeloid/NK sarcoma in an aleukemic patient evolved in refractory acute leukemia. Leuk Res. 2009 Sep;33(9):1294–6.
3.
Demir D, Hekimgil M, Karaca E, Ulusoy Y, Özdemir HH, Saydam G, et al. Clinicopathological characteristics, genetics and prognosis of patients with myeloid sarcoma: a single-center study. J Clin Pathol. 2023 Apr;76(4):244–51.
4.
Shallis RM, Gale RP, Lazarus HM, Roberts KB, Xu ML, Seropian SE, et al. Myeloid sarcoma, chloroma, or extramedullary acute myeloid leukemia tumor: a tale of misnomers, controversy and the unresolved. Blood Rev. 2021 May;47:100773.
5.
Katagiri T, Ushiki T, Masuko M, Tanaka T, Miyakoshi S, Fuse K, et al. Successful 5-azacytidine treatment of myeloid sarcoma and leukemia cutis associated with myelodysplastic syndrome: a case report and literature review. Medicine. 2017 Sep;96(36):e7975.
6.
Niscola P, Palombi M, Trawinska MM, Tendas A, Giovannini M, Scaramucci L, et al. Managing myelodysplastic syndromes in very old patients: a teaching case report. Clin Interv Aging. 2013;8:391–4.
7.
DiNardo CD, Jonas BA, Pullarkat V, Thirman MJ, Garcia JS, Wei AH, et al. Azacitidine and venetoclax in previously untreated acute myeloid leukemia. N Engl J Med. 2020;383(7):617–29.
8.
Ball S, Knepper TC, Deutsch YE, Samra W, Watts JM, Bradley TJ, et al. Molecular annotation of extramedullary acute myeloid leukemia identifies high prevalence of targetable mutations. Cancer. 2022 Sep 15;128(21):3880–7.
9.
Greenberg PL, Tuechler H, Schanz J, Sanz G, Garcia-Manero G, Solé F, et al. Revised international prognostic scoring system for myelodysplastic syndromes. Blood. 2012;120(12):2454–65.
10.
Sharma N, Liesveld JL. NPM 1 mutations in AML-the landscape in 2023. Cancers. 2023 Feb 12;15(4):1177.
11.
DiNardo CD, Tiong IS, Quaglieri A, MacRaild S, Loghavi S, Brown FC, et al. Molecular patterns of response and treatment failure after frontline venetoclax combinations in older patients with AML. Blood. 2020 Mar 12;135(11):791–803.
12.
Pratz KW, Jonas BA, Pullarkat V, Recher C, Schuh AC, Thirman MJ, et al. Measurable residual disease response and prognosis in treatment-naïve acute myeloid leukemia with venetoclax and azacitidine. J Clin Oncol. 2022 Mar 10;40(8):855–65.
13.
Niscola P, Tendas A, Scaramucci L, Giovannini M, Cupelli L, Fratoni S, et al. Gingival myeloid sarcoma in myelodysplastic syndrome. Support Care Cancer. 2013 Apr;21(4):917–8.
14.
Findakly D, Amar S. A rare case of leukemia cutis as the first presentation of a myelodysplastic syndrome to acute myeloid leukemia transformation. Cureus. 2020 Jun 19;12(6):e8698.
15.
Zhu LX, Chen RR, Wang LL, Sun JN, Zhou D, Li L, et al. A real-world study of infectious complications of venetoclax combined with decitabine or azacitidine in adult acute myeloid leukemia. Support Care Cancer. 2022 Aug;30(8):7031–8.
© 2023 S. Karger AG, Basel
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
2023
You do not currently have access to this content.