Successful treatment of acute myeloid leukemia co-expressing NUP98/NSD1 and FLT3/ITD with preemptive donor lymphocyte infusions

Int J Hematol. 2019 Oct;110(4):512-516. doi: 10.1007/s12185-019-02665-3. Epub 2019 May 27.

Abstract

Patients with acute myeloid leukemia (AML) co-expressing NUP98/NSD1 and FLT3/ITD have a dismal prognosis despite undergoing hematopoietic stem cell transplantation (HSCT). There are a few studies on successful treatment of relapsed AML co-expressing NUP98/NSD1 and FLT3/ITD. We report a refractory case of molecular relapse of AML co-expressing NUP98/NSD1 and FLT3/ITD post-matched sibling HSCT. Donor lymphocyte infusion (DLI) at an early stage of post-transplantation resulted in complete molecular remission for 29 months with durable chronic graft-versus-host disease. Our case suggests the clinical efficacy of preemptive DLI following minimal residual disease analysis for the treatment of refractory AML.

Keywords: Acute myeloid leukemia; FLT3/ITD; NUP98/NSD1; Peripheral blood stem cell transplantation; Preemptive donor lymphocyte infusions.

MeSH terms

  • Allografts
  • Child
  • Gene Expression*
  • Graft vs Host Disease
  • Graft vs Leukemia Effect
  • Hematopoietic Stem Cell Transplantation*
  • Histone-Lysine N-Methyltransferase*
  • Humans
  • Leukemia, Myeloid, Acute / genetics*
  • Leukemia, Myeloid, Acute / therapy*
  • Lymphocyte Transfusion*
  • Male
  • Neoplasm Recurrence, Local
  • Neoplasm, Residual
  • Nuclear Pore Complex Proteins*
  • Remission Induction
  • Tissue Donors
  • Treatment Outcome
  • fms-Like Tyrosine Kinase 3*

Substances

  • Nuclear Pore Complex Proteins
  • Nup98 protein, human
  • Histone-Lysine N-Methyltransferase
  • NSD1 protein, human
  • FLT3 protein, human
  • fms-Like Tyrosine Kinase 3