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Shatilova A, Girshova L, Zaytsev D, Budaeva I, Mirolyubova Y, Ryzhkova D, Grozov R, Bogdanov K, Nikulina T, Motorin D, Zammoeva D, Efremova S, Ivanov V, Petukhov A, Alekseeva Y, Zaritskey A. The myeloid sarcoma treated by Venetoclax with hypomethylating agent followed by stem cell transplantation: rare case report. BMC Womens Health 2021; 21:184. [PMID: 33933047 PMCID: PMC8088676 DOI: 10.1186/s12905-021-01328-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 04/22/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Myeloid sarcoma (MS) is a very rare condition, develops both in patients with other hematological neoplasms, and as isolated tumor. MS of the gynecologic tract is extremely rare. An available literature data about diagnosis and management of MS is summarized in the article. The role of chemotherapy, radiation therapy, surgery and bone marrow transplantation in the treatment is discussed. Polychemotherapy and allogeneic bone marrow transplantation were suggested to be the optimal treatment strategy of MS of the gynecological tract. The use of new targeted agents results in promising clinical data. CASE PRESENTATION We are presenting a rare clinical case of a MS of the uterine cervix with concomitant bone marrow involvement and describe all the peculiarities of the clinical course, diagnosis, and treatment. The patient received chemotherapy followed by allogeneic bone marrow transplantation. The pre-transplant therapy allowed us to perform allogeneic bone marrow transplantation with the deepest response possible: complete PET-negative and MRD-negative remission of the disease. CONCLUSIONS MS remains a subject of discussion regarding its diagnostic and therapeutic aspects. The use of novel targeting agents can be perspective option for patient with extramedullary disease.
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Affiliation(s)
- Aleksina Shatilova
- Personalized Medicine Centre, Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341.
| | - Larisa Girshova
- Personalized Medicine Centre, Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Daniil Zaytsev
- Personalized Medicine Centre, Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Irina Budaeva
- Personalized Medicine Centre, Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Yuliya Mirolyubova
- Personalized Medicine Centre, Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Darya Ryzhkova
- Personalized Medicine Centre, Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Roman Grozov
- Personalized Medicine Centre, Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Konstantin Bogdanov
- Personalized Medicine Centre, Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Tatiana Nikulina
- Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Dmitriy Motorin
- Personalized Medicine Centre, Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Darina Zammoeva
- Personalized Medicine Centre, Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Svetlana Efremova
- Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Vladimir Ivanov
- Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Alexey Petukhov
- Personalized Medicine Centre, Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Yuliya Alekseeva
- Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Andrey Zaritskey
- Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
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Mandelker D, Dal Cin P, Jacene HA, Armand P, Stone RM, Lindeman NI. Refractory myeloid sarcoma with a FIP1L1-PDGFRA rearrangement detected by clinical high throughput somatic sequencing. Exp Hematol Oncol 2015; 4:30. [PMID: 26457233 PMCID: PMC4599757 DOI: 10.1186/s40164-015-0026-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 09/29/2015] [Indexed: 01/13/2023] Open
Abstract
Next generation sequencing (NGS) is increasingly being used clinically to characterize the molecular alterations found in patients’ tumors. These testing results have the potential to affect clinical care by guiding therapeutic approaches based upon genotype. NGS based testing approaches have a distinct advantage over provider-ordered single gene testing in that they can detect unexpected, yet clinically important genetic changes. Here, we illustrate this principle with the case of a 33-year-old man with myeloid sarcoma that was refractory to six different chemotherapeutic regimens. Our clinical NGS assay detected an unanticipated FIP1L1-PDGFRA rearrangement in his tumor. The patient was immediately placed on Imatinib therapy to which he responded, and remains in remission 10 months after the rearrangement was initially detected.
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Affiliation(s)
- Diana Mandelker
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., Boston, MA 02115 USA
| | - Paola Dal Cin
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., Boston, MA 02115 USA
| | - Heather A Jacene
- Division of Nuclear Medicine, Department of Imaging, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Ave, Boston, MA 02215 USA
| | - Philippe Armand
- Division of Hematological Malignancies, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Ave, Boston, MA 02215 USA
| | - Richard M Stone
- Division of Hematological Malignancies, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Ave, Boston, MA 02215 USA
| | - Neal I Lindeman
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St., Boston, MA 02115 USA
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Barraco D, Carobolante F, Candoni A, Simeone E, Piccaluga P, Tabanelli V, Fanin R. Complete and long-lasting cytologic and molecular remission of FIP1L1-PDGFRA-positive acute eosinophil myeloid leukaemia, treated with low-dose imatinib monotherapy. Eur J Haematol 2014; 92:541-545. [PMID: 24460680 DOI: 10.1111/ejh.12272] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2014] [Indexed: 11/03/2023]
Abstract
Myeloproliferative neoplasms associated with FIP1L1-PDGFR rearrangements represent a rare subset of myeloid and lymphoid malignancies, characterised by the presence of eosinophilia and abnormalities of PDGFRA, PDGFRB or FGFR1 genes. The fusion product of such genes is a tyrosine kinase oncoprotein sensitive to imatinib, which to date results to be the standard of care for FIP1L1-PDGFRA-positive chronic myeloproliferative disorders with eosinophilia. However, the coexistence of FIP1L1-PDGFRA rearrangement associated with acute myeloid leukaemia is extremely rare. Here, we report a rare case of FIP1L1-PDGFRA-positive acute myeloid leukaemia, with marked peripheral blood and bone marrow eosinophilia, treated with low dose of imatinib monotherapy, achieving a rapid and long-lasting complete cytologic and molecular remission, without need for intensive chemotherapy.
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Affiliation(s)
- Daniela Barraco
- Division of Haematology and Bone Marrow Transplantation, Azienda Ospedaliero Universitaria SM Misericordia, University of Udine, Udine, Italy
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