Successful Outcome of Allogeneic Stem Cell Transplant in a Patient with FLT3-ITD and CBL Mutations in Refractory/ Relapsed AML Accompanied by Pulmonary Cavity: A Case Report

Li Z1#, Pan Y2#, Chen J1, Li X1 and Chen P2*

1Hematopoietic Stem Cell Transplantation Center, The Tenth Affiliated Hospital of Southern Medical University (Dongguan People’s Hospital), Southern Medical University, China 2The Tenth Affiliated Hospital of Southern Medical University (Dongguan People’s Hospital), Southern Medical University or The First School of Clinical Medicine, Southern Medical University, China #These authors have contributed equally to this work

^*Correspondance to: Peier Chen 

 PDF  Full Text Case Report | Open Access

Abstract:

Background: The Fms-Like Tyrosine kinase 3 (FLT3) gene is frequently mutated in adult Acute Myeloid Leukemia (AML), with a detection rate of approximately 30%. Patients harboring both FLT3-ITD and Casitas B-lineage Lymphoma proto-oncogene (CBL) frequently encounter relapse or refractoriness, posing a significant challenge in treatment as conventional drugs have limited efficacy in clinical practice. Case Report: We present a rare and complex case of successful transplantation of refractory/ relapsed AML with FLT3-ITD and CBL double mutations in a young female patient. Chemotherapy was initially administered to treat AMI; however, she developed persistent agranulocytosis, recurrent hyperthermia, and a severe lung infection, subsequently progressing into a serious pulmonary cavity. After receiving active anti-infective treatment and targeted drug therapy, there was slight improvement in the patient's condition. The donor screening and matching for stem cell transplantation were conducted once the patient's condition had stabilized, leading to a successful allogeneic Hematopoietic Stem Cell Transplantation (allo-HSCT). Fortunately, the patient exhibited recovery of hematopoietic function and showed improvement after the transplant. Conclusion: In conclusion, for patients with refractory/relapsed AML harboring FLT3-ITD mutations combined with CBL mutations, timely initiation of remission induction therapy followed by prompt and proactive HSCT can significantly improve patient outcomes.

Keywords:

Acute myeloid leukemia; Fms-like tyrosine kinase 3; Casitas B-lineage lymphoma proto-oncogene; Hematopoietic stem cell transplantation; Targeted therapy

Cite the Article:

Li Z, Pan Y, Chen J, Li X, Chen P. Successful Outcome of Allogeneic Stem Cell Transplant in a Patient with FLT3- ITD and CBL Mutations in Refractory/ Relapsed AML Accompanied by Pulmonary Cavity: A Case Report. Ann Clin Case Rep. 2024; 9: 2618..