FLT3 inhibitors as MRD-guided salvage treatment for molecular failure in FLT3 mutated AML.

Patients with FLT3-mutated AML have a high relapse rate and suboptimal outcomes. Many have co-mutations suitable for measurable residual disease (MRD) monitoring by RT-qPCR and those destined to relapse can be identified by high or rising levels of MRD, called molecular failure.  This provides a window for pre-emptive intervention, but there is little evidence to guide treatment.

Optimising care for UK patients with acute myeloid leukaemia.

Acute myeloid leukaemia is a rare cancer, with about 3000 cases diagnosed each year in the UK. Diagnosis is based on patient history, blood and bone marrow tests and, in some cases, imaging. Chemotherapy is the mainstay of treatment for acute myeloid leukaemia, with eligible patients also undergoing allogeneic haematopoietic stem cell transplantation, which can be curative.

Treatment of older patients with acute myeloid leukemia--new agents.

The experience of most collaborative study groups is that the outcome for older patients has, unlike in younger patients, failed to improve over the last two decades. In addition there are a substantial number of older patients who do not enter collaborative group trials because they are not considered suitable for an intensive chemotherapy approach. During this era many combinations of chemotherapeutic agents at different dose levels have been tried.

Autoimmune haemolytic anaemia as the presenting manifestation of agnogenic myeloid metaplasia.

We report an unusual case of a 40-year-old female patient with a severe case of direct Coombs positive haemolytic anaemia, moderate hepatomegaly and marked splenomegaly. Her initial response to steroids was transient and was rapidly followed by a relapse. Therefore, she underwent splenectomy both as a therapeutic measure and to rule out an underlying lymphoproliferative disorder.