Abstract:
Activating mutations and fusions of the ALK oncogene have been identified as drivers in a number of malignancies. Crizotinib and subsequent ALK tyrosine kinase inhibitors have improved treatment outcomes for these patients. In this paper, we discuss the case of an adolescent patient with acute myeloid leukemia, who was identified to have an activating ALK fusion, which is a rare finding and has never been reported in cases of AML without monosomy 7. Crizotinib was added to this patient\'s frontline therapy and was well tolerated. In cases of more common gene alterations, existing data supports the use of targeted agents as post-HSCT maintenance therapy; however, crizotinib was not able to be used post-HSCT for this patient due to the inability to obtain insurance coverage.
摘要:
ALK癌基因的激活突变和融合已被鉴定为许多恶性肿瘤的驱动因素。克唑替尼和随后的ALK酪氨酸激酶抑制剂改善了这些患者的治疗结果。在本文中,我们讨论了一个患有急性髓细胞性白血病的青少年患者的案例,被确定为具有激活的ALK融合,这是一个罕见的发现,从未在没有单体7的AML病例中报道过。克唑替尼被添加到该患者的一线治疗中,耐受性良好。在更常见的基因改变的情况下,现有数据支持使用靶向药物作为HSCT后维持治疗;然而,由于无法获得保险,该患者在HSCT后无法使用克唑替尼.