Table 2. Patient Characteristics of patients that developed D835 Mutation upon clinical resistance to FLT3 inhibitors.
Patient | Age | # Prior Treatments | Baseline | Best response to FLT3 inhibitor |
At Disease Progression | Treatment after FLT3 Inhibitor |
Response | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
WBC (x109/L) |
PBB (%) | BMB (%) | Ratio Allele Burden ITD |
Cytogenetic | WBC (x109/L) |
PBB (%) | BMB (%) | Ratio Allele Burden ITD/D835 |
Cytogenetic | ||||||
1 | 37 | 2 | 2.4 | 33 | 66 | ND | Misc | CRp | 20.5 | 81 | 56 | ND | ND | IA+ Sorafenib | NR |
2 | 87 | 1 | 7.1 | 89 | 80 | ND | Dip | BMBR | 23 | 81 | 82 | ND | Dip | Azacytadine + Sorafenib | NR |
3 | 69 | 2 | 5.4 | 20 | 86 | Size 371 and 39.7% | Dip | CR | 14 | 71 | 91 | 0.47/0.5 3 | Dip | Phase 1 Protocol | NR |
4 | 25 | 4 | 1.7 | 33 | 60 | ND | Com | NR | 10.1 | 97 | 76 | ND | Com | Phase 1 Protocol | NR |
5 | 79 | 1 | 21 | 51 | 52 | 0.007 and 0.167 | Dip | NR | 5.1 | 25 | 63 | 0.029 and 0.318/0. 210 | Dip | Azacytadine + Sorafenib | NR |
6 | 38 | 5 | 9.8 | 85 | 95 | ND | Dip | NR | 17.9 | 63 | 70 | ND | Dip | Sorafenib | NR |
7 | 43 | 1 | 60 | 95 | 92 | 0.384 | -7 | CRp | 28 | 86 | 47 | 0.388/0. 265 | Dip | Plerixafor + Sorafenib | NR |
8 | 23 | 4 | 74 | 92 | 86 | ND | ND | NR | 67 | 96 | 88 | ND | Com | Phase 1 Protocol | NR |
9* | 21 | 2 | 3 | 13 | 55 | ND | −7q | NR | 1.8 | 0 | 23 | 0.231/0. 384 | −7q | SCT | Relapsed within 2 months |
10 | 67 | 2 | 60 | 58 | 66 | 0.26 | Dip | BMBR | 13.9 | 83 | 55 | 0.023/0. 33 | Dip | Plerixafor + Sorafenib. FA | NR |
11 | 38 | 4 | 7.8 | 90 | 90 | ND | Com | NR | 43 | 91 | 80 | ND | Com | Decitabine + GO | NR |
12* | 33 | 3 | 0.2 | 0 | 25 | 0.065 | Ins | BMBR | 23 | 67 | 74 | 0.124/0. 134 | Misc | SCT | Relapsed within 3 months |
13 | 52 | 2 | 19.2 | 89 | 93 | ND | Misc | CRp | 105 | 55 | 80 | ND | Misc | Phase 1 Protocol | NR |
14 | 75 | 2 | 65.2 | 1 | 40 | ND | Dip | CR | 37.6 | 6 | 32 | 0.856/0.393 | Dip | Plerixafor + Sorafenib | NR |
15 | 64 | 2 | 1.6 | 6 | 20 | ND | Dip | NR | 2.6 | 80 | 78 | Ratio 0.01/0.159 | ND | ND | NR |
WBC: White Blood Cells, PBB: Peripheral Blood Blasts, BMB: Bone Marrow Blasts, CR: Complete Remission, CRp: Complete Remission with incomplete platelet recovery, NR: No Response, BMBR: Bone Marrow Blast Reduction, ND: Not Done, Dip: Diploid, Misc: Miscellaneous, Insu: Insufficient, Com: Complex, I: Idarubicin, F: Fludarabine, A: Ara C, GO: gemtuzumab Ozogamicin, SCT: Stem Cell Transplant.
These 2 patients had documented combined ITD/D835 mutation at the time of disease progression after transplantation.