{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T05:29:39Z","timestamp":1765776579590,"version":"3.48.0"},"reference-count":11,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T00:00:00Z","timestamp":1765756800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82170151"],"award-info":[{"award-number":["82170151"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006407","name":"Natural Science Foundation of Henan Province","doi-asserted-by":"publisher","award":["232300420238"],"award-info":[{"award-number":["232300420238"]}],"id":[{"id":"10.13039\/501100006407","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      This case is reported due to its novelty in demonstrating the efficacy of avapritinib, a selective\n                      <jats:italic>KIT<\/jats:italic>\n                      inhibitor, in a rare systemic mastocytosis-associated acute myeloid leukemia (SM-AML) patient with non-D816V\n                      <jats:italic>KIT<\/jats:italic>\n                      mutations and\n                      <jats:italic>RUNX1::RUNX1T1<\/jats:italic>\n                      fusion. Avapritinib is established for\n                      <jats:italic>KIT<\/jats:italic>\n                      D816V-mutant advanced systemic mastocytosis (AdvSM). However, its role in non-D816V\n                      <jats:italic>KIT<\/jats:italic>\n                      mutant SM-AHN post-allogeneic hematopoietic stem cell transplantation (Allo-HSCT) remains unexplored, highlighting the need to document this therapeutic challenge and outcome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      A 15-year-old Asian male with SM-AML underwent induction chemotherapy, targeted therapy, and Allo-HSCT, but experienced graft failure with persistent mastocytosis. Post-Allo-HSCT avapritinib was initiated due to high proportion of mast cells (MCs). After 14 months, the patient achieved minimal residual disease (MRD)-negative complete remission, full donor chimerism (100%), and sustained hematologic recovery without adverse events. MC burden declined from 14.06% to 0.3%, and\n                      <jats:italic>RUNX1::RUNX1T1<\/jats:italic>\n                      fusion became undetectable.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This case highlights avapritinib\u2019s potential as a salvage therapy for non-D816V\n                      <jats:italic>KIT<\/jats:italic>\n                      mutant SM-AML post-Allo-HSCT, effectively reducing MC clones and restoring donor chimerism. It suggests that avapritinib may bridge therapeutic gaps for atypical\n                      <jats:italic>KIT<\/jats:italic>\n                      -mutant systemic mastocytosis with associated hematologic neoplasm (SM-AHN) that is ineligible for Allo-HSCT or relapsed. Prospective trials are warranted to validate its efficacy, optimize dosing, and explore synergies with Allo-HSCT, offering new strategies for these high-risk patients.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2025.1728830","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T05:24:54Z","timestamp":1765776294000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Avapritinib in the treatment of systemic mastocytosis with associated acute myeloid leukemia after poor graft function following allogeneic hematopoietic stem cell transplantation: a case study and review of the 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