Platelet-derived growth factor receptor-alpha-positive myeloid neoplasm presenting as eosinophilic gastrointestinal disease.
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ABSTRACT:
SUBMITTER: Constantine GM
PROVIDER: S-EPMC8456709 | biostudies-literature | 2020 Jun
REPOSITORIES: biostudies-literature
Publications
Platelet-derived growth factor receptor-alpha-positive myeloid neoplasm presenting as eosinophilic gastrointestinal disease.
Constantine Gregory M GM Ware JeanAnne J Brown Thomas T Thumm Lauren L Kamal Natasha N Kumar Sheila S Kleiner David D Maric Irina I Klion Amy D AD
The journal of allergy and clinical immunology. In practice 20200212 6
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Project description:Myeloid/lymphoid neoplasm with eosinophilia (MLN-Eo) is a World Health Organization (WHO) established category of hematologic malignancies primarily arising in adults. We discuss an 8-month-old infant who presented with clinical features similar to those of juvenile myelomonocytic leukemia (JMML) but who was diagnosed with MLN-Eo driven by an ETV6-FLT3 fusion. Results of patient-derived leukemia ex vivo studies demonstrated increased sensitivity to type I FLT3 inhibitors as compared with type II inhibitors. Treatment with the type I inhibitor gilteritinib resulted in complete immunophenotypic and cytogenetic remission. This patient subsequently underwent a hematopoietic stem cell transplant and remains in complete remission 1 year later. This is the youngest patient reported with an ETV6-FLT3 fusion and adds to the mounting reports of FLT3-rearranged MLN-Eo, supporting its addition to the WHO classification. Furthermore, this case highlights the clinical utility of ex vivo drug testing of targeted therapies.
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