Table 1.

Clinical course for a 57-year-old man diagnosed with inv(16) AML

Clinical courseTreatmentKaryotypeFISH, %NGS targeted panelRatio KRAS G12D mutant: wild type
BlastsEosinophils
Initial diagnosis 7+3, consolidation HiDAC (2 cycles) 46,XY, inv(16)(p13.1q22)[2/15] 40.3 n/d n/d n/d 
First relapse MEC n/d 3 n/d n/d n/d 
Second relapse FLAG n/d 1.3 n/d 0 0 
Third relapse Decitabine (4 cycles) 46,XY, inv(16)(p13.1q22)[1/13] 5 n/d 0 0 
Fourth relapse FLAG 48,XY, +8, inv(16)(p13.1q22), +20[17/20] 42-45 No mutations called 0.02 QNS 
Fifth relapse Azacitidine + venetoclax n/d 47 n/d 0.844 QNS 
Disease progression None 46,XY, add(9)(p24), inv(16)(p13.1q22), t(17;22)(q23;q13)[20] 48 KRAS G12D 0.912 0.877 
Clinical courseTreatmentKaryotypeFISH, %NGS targeted panelRatio KRAS G12D mutant: wild type
BlastsEosinophils
Initial diagnosis 7+3, consolidation HiDAC (2 cycles) 46,XY, inv(16)(p13.1q22)[2/15] 40.3 n/d n/d n/d 
First relapse MEC n/d 3 n/d n/d n/d 
Second relapse FLAG n/d 1.3 n/d 0 0 
Third relapse Decitabine (4 cycles) 46,XY, inv(16)(p13.1q22)[1/13] 5 n/d 0 0 
Fourth relapse FLAG 48,XY, +8, inv(16)(p13.1q22), +20[17/20] 42-45 No mutations called 0.02 QNS 
Fifth relapse Azacitidine + venetoclax n/d 47 n/d 0.844 QNS 
Disease progression None 46,XY, add(9)(p24), inv(16)(p13.1q22), t(17;22)(q23;q13)[20] 48 KRAS G12D 0.912 0.877 

At each relapse, treatment, karyotype, fluorescence in situ hybridization (FISH), mutations detected by NGS targeted panel, and ddPCR KRAS mutation detection are indicated when available.

MEC, mitoxantrone, etoposide, and cytarabine; n/d, not done; QNS, quantity not sufficient.

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