得病的是我表哥，感情很好，就跟亲哥一样，大概三年前查出来这个病，我妈知道后连续几天以泪洗面。两年前做了骨髓移植，本来恢复的还行，但是前阵子复发了，最近一直在住院化疗，靶向治疗，目前几个病变基因转阴了或者表达量下降了。现在的情况想知道是否需要二次移植还是继续观察一段时间。 谢谢各位业内的姐妹能帮忙看看，或者帮忙推荐一下美国这边的专家，想多问几个opinion。 A 50-year-old male was diagnosed with acute myeloid leukemia on December 1, 2022. The test results showed FLT3-ITD mutation, IDH1 mutation, WT1 mutation, CEBPA N-terminal mutation, NUP98-KDM5A fusion gene, and normal chromosome karyotype. After chemotherapy, he underwent haploidentical allogeneic hematopoietic stem cell transplantation on February 16, 2023, and his condition was stable after the transplantation. On February 5, 2025, he was infected with the herpes zoster virus. During a review two years later, on February 18, 2025, the WT1 expression was 1.246%, FLT3-ITD was negative, chimerism was 99%, and MRD was negative. On March 25, 2025, during re-examination, WT1 was 7.131%, FLT3-ITD was negative, MRD was 2%, and chimerism was 99%. On April 2, 2025, the examination results were as follows: MRD 4%, NUP98-KDM5A 0.87%, IDH1 mutation was present, WT1 was 2.1%, FLT3-ITD was negative, and CEBPA mutation was negative. Chemotherapy with the DCAG regimen was initiated on April 2, 2025 and finished on April 21,2025. On May 9, 2025, the examination showed: MRD was negative, NUP98-KDM5A was 0.077%, WT1 was not tested, CEBPA was negative, FLT3-ITD was negative, and chimerism was 99%. On June 4, 2025, the examination results were: NUP98-KDM5A was 0.054%, WT1 was not tested, CEBPA was negative, FLT3-ITD was negative, chimerism was 99%, and MRD was negative. On July 6, 2025, the examination showed: NUP98-KDM5A was negative, WT1 was 0.123%, IDH mutation was negative, CEBPA was negative, FLT3-ITD was negative, chimerism was 99%, and MRD was negative. From May 12, 2025 to June 2, 2025: Sorafenib 0.4g, BID; Selinexor 60mg, twice a week. From June 9, 2025 to June 16, 2025: Sorafenib 0.4g, BID. Starting from June 17, 2025: Sorafenib 0.2g, BID; Selinexor 60mg, once a week. What is the subsequent treatment and is transplantation necessary?
A 50-year-old male was diagnosed with acute myeloid leukemia on December 1, 2022. The test results showed FLT3-ITD mutation, IDH1 mutation, WT1 mutation, CEBPA N-terminal mutation, NUP98-KDM5A fusion gene, and normal chromosome karyotype. After chemotherapy, he underwent haploidentical allogeneic hematopoietic stem cell transplantation on February 16, 2023, and his condition was stable after the transplantation.
On February 5, 2025, he was infected with the herpes zoster virus.
During a review two years later, on February 18, 2025, the WT1 expression was 1.246%, FLT3-ITD was negative, chimerism was 99%, and MRD was negative.
On March 25, 2025, during re-examination, WT1 was 7.131%, FLT3-ITD was negative, MRD was 2%, and chimerism was 99%.
On April 2, 2025, the examination results were as follows: MRD 4%, NUP98-KDM5A 0.87%, IDH1 mutation was present, WT1 was 2.1%, FLT3-ITD was negative, and CEBPA mutation was negative.
Chemotherapy with the DCAG regimen was initiated on April 2, 2025 and finished on April 21,2025. On May 9, 2025, the examination showed: MRD was negative, NUP98-KDM5A was 0.077%, WT1 was not tested, CEBPA was negative, FLT3-ITD was negative, and chimerism was 99%.
On June 4, 2025, the examination results were: NUP98-KDM5A was 0.054%, WT1 was not tested, CEBPA was negative, FLT3-ITD was negative, chimerism was 99%, and MRD was negative.
On July 6, 2025, the examination showed: NUP98-KDM5A was negative, WT1 was 0.123%, IDH mutation was negative, CEBPA was negative, FLT3-ITD was negative, chimerism was 99%, and MRD was negative.
From May 12, 2025 to June 2, 2025: Sorafenib 0.4g, BID; Selinexor 60mg, twice a week.
From June 9, 2025 to June 16, 2025: Sorafenib 0.4g, BID.
Starting from June 17, 2025: Sorafenib 0.2g, BID; Selinexor 60mg, once a week.
What is the subsequent treatment and is transplantation necessary?