Expert Cancer Panel: Relapsed AML in the leptomeningeal and parenchymal CNS

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Published
Recorded on 10/9/2021

60-year-old male with relapsed AML in the leptomeningeal and parenchymal CNS.

Summary:
- For a patient with CNS relapse (parenchymal and leptomeningeal) of AML with inversion 16 and c-kit mutation, and MRD positive disease in the bone marrow, the panel recommends initial CNS directed therapy with alternating cytarabine and methotrexate twice per week until CSF clearance followed by maintenance.
- The patient should be evaluated by radiation oncology for consideration of radiation therapy. After CSF clearance, the recommendation would be HIDAC-based therapy followed by allogeneic stem cell transplant if transplant eligible. If the patient is not a transplant candidate, venetoclax should be continued with consideration of the addition of dasatinib given off-target effects on the c-kit mutation.


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Oncology
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