Micheva Ilina, Gerov Vladimir, Dimitrova Stela, Efraim Merlin
UMHAT "Sveta Marina" Medical University, Varna, Bulgaria.
Case Rep Hematol. 2021 May 26;2021:1717506. doi: 10.1155/2021/1717506. eCollection 2021.
Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph + ALL) is an aggressive disease with poor outcomes. Despite the incorporation of tyrosine kinase inhibitors (TKIs) in the therapeutic strategies, patients who relapse after chemotherapy plus TKI have poor overall survival (OS) and less chance to proceed to hematopoietic stem cell transplantation (HSCT) which remains the only curative approach. Therefore, new drugs, such as antibody-targeted therapies alone or in combination with TKIs, offer new therapeutic options for those patients. However, the combination of inotuzumab plus ponatinib has limited application. We present a case of a patient affected by Ph + ALL with T315I mutation successfully treated after early relapse with inotuzumab plus ponatinib, followed by allogeneic HSCT and ponatinib maintenance.
费城染色体阳性急性淋巴细胞白血病(Ph+ALL)是一种侵袭性疾病,预后较差。尽管酪氨酸激酶抑制剂(TKIs)已被纳入治疗策略,但化疗联合TKI治疗后复发的患者总生存期(OS)较差,进行造血干细胞移植(HSCT)的机会也较少,而HSCT仍然是唯一的治愈方法。因此,诸如单独使用抗体靶向疗法或与TKIs联合使用的新药,为这些患者提供了新的治疗选择。然而,因诺妥珠单抗联合波纳替尼的应用有限。我们报告一例Ph+ALL伴T315I突变的患者,在早期复发后成功接受因诺妥珠单抗联合波纳替尼治疗,随后进行异基因HSCT及波纳替尼维持治疗。