KIT D816V Positive Acute Mast Cell Leukemia Associated with Normal Karyotype Acute Myeloid Leukemia

Figure 6

Serum tryptase levels from diagnosis of MCL-AML to date. Serum tryptase levels were markedly increased at the diagnosis (184 μg/L, October 2015) and decreased transiently to 41 μg/L after two cycles of cladribine (5 days, with one month of interval: December 2015; January 2016). However, one month later (February 2016), the serum tryptase levels increased again to 123 μg/L, and the BM aspirate showed 47% myeloblasts. At that time, the patient received two cycles of combined therapy with idarubicin and cytosine arabinoside (3 + 7 days) (February 2016; April 2016) followed by two cycles of high-dose cytosine arabinoside (June 2016; July 2016). At day  +32 of reinduction chemotherapy (May 2016), the patient achieved complete hematological remission, and the serum tryptase levels decreased to 8 mg/L, remaining normal to date. At the end of August 2016, the patient received allogeneic hematopoietic stem cell transplantation (HSCT) from her sister. By the time of this report (November 2017, 24 months after the diagnosis, 15 months after HSCT), she maintains a complete hematological remission and a complete chimerism in peripheral blood.