Klocke Heather, Dong Zhao Ming, O'Brien Craig, Burwick Nicholas, Richard Robert E, Wu Daniel Y, Chauncey Thomas R, Graf Solomon A
Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.
Department of Pathology, University of Washington Medicine, Seattle, WA, USA.
Case Rep Hematol. 2020 Oct 10;2020:8811673. doi: 10.1155/2020/8811673. eCollection 2020.
T/myeloid mixed-phenotype acute leukemia not otherwise specified (MPAL NOS) is an uncommon and aggressive leukemia without well-established treatment guidelines, particularly when relapsed. Venetoclax plus a hypomethylating agent offers a promising option in this situation since studies support its use in both acute myeloid and, albeit with fewer data to date, acute T-cell-lymphoblastic leukemias. We report the successful eradication of T/myeloid MPAL NOS relapsed after allogeneic stem cell transplant with venetoclax plus decitabine. A consolidative allogeneic stem cell transplant from a second donor was subsequently performed, and the patient remained without evidence of disease more than one year later. Further investigation is indicated to evaluate venetoclax combined with hypomethylating agents and/or other therapies for the management of T/myeloid MPAL NOS.
未另行指定的T/髓系混合表型急性白血病(MPAL NOS)是一种罕见且侵袭性强的白血病,没有成熟的治疗指南,尤其是在复发时。维奈克拉联合一种去甲基化药物在这种情况下提供了一个有前景的选择,因为研究支持其在急性髓系白血病中的应用,尽管到目前为止在急性T淋巴细胞白血病中的数据较少。我们报告了1例异基因干细胞移植后复发的T/髓系MPAL NOS患者,使用维奈克拉联合地西他滨成功清除疾病。随后进行了来自第二位供者的巩固性异基因干细胞移植,一年多后患者仍无疾病证据。需要进一步研究来评估维奈克拉联合去甲基化药物和/或其他疗法用于治疗T/髓系MPAL NOS。