Mr Razvan Preda is a 32 yo, who was referred to UCLH after being diagnosed at Luton and Dunstable in late December 2024 with AML-MR and concurrent flu A. He has no significant medical history.
He received FLA-Ida and achieved a bone marrow response but then developed leukaemia cutis at the start of cycle 2 (biopsy proven, initially diagnosed as Sweets syndrome), and has now shown clonal evolution in his most recent marrow with dual loss of TP53 (8/5/25) , although no clear frank relapse (3% aberrant phenotype blasts). At diagnosis, pathogenic variants in ASXL1, NRAS PTPN11 and EZH2 were detected and on his most recent marrow the ASXL1 and EXH2 persist but he has a developed a TP53 variant but also a new low level (11%) loss of TP53 gene.
He had one cycle of venetoclax plus azacitdine with a mixed response leading to resolution of some skin lesions but other areas have progressed and new skin lesions developed on his torso and arms. The NGS on the skin biopsy is the same as in the most recent marrow, with nothing targetable. The skin lesions have never been particularly PET avid but a PET CT at the end of this cycle of venetoclax plus azacitdine has also shown new splenic lesions, in keeping with disease.
He is Romanian but speaks excellent English and is a plumber by trade. He is married with 2 children aged 2-3 and 7. He has one step brother and one step sister but no full siblings. We have identified 2 fully matched unrelated donors.
