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一名年轻的急性髓系白血病患者,不适合进行强化诱导治疗及后续自体造血干细胞移植,在接受阿扎胞苷和维奈克拉治疗后达到微小残留病阴性的完全缓解。

MRD negative CR after azacitidine and venetoclax in a young patient with AML, unfit for intensive induction followed by ASCT.

作者信息

Shukla Deepak Kumar, Katewa Satyendra, Porwal Ravikant, Dara Ravi, Sharma Lalit, Sharma Rahul, Arora Aadesh

机构信息

Consultant Medical Oncology, Manipal Comprehensive Cancer Center, Manipal Hospital Jaipur, India.

Consultant - Pediatric Hematology Oncology & Bone Marrow Transplant, Manipal Comprehensive Cancer Center , Manipal Hospital Jaipur, India.

出版信息

Leuk Res Rep. 2021 Sep 6;16:100267. doi: 10.1016/j.lrr.2021.100267. eCollection 2021.

Abstract

A subset of AML patients are unfit for 7+3 induction at the time of diagnosis. Present case highlights the use of azacitidine and venetoclax in a patient with intermediate risk AML with WT-1 mutation,deemed unfit for intensive induction in view of poor general condition and comorbid illness. After venetoclax and azacitidine patient was negative for measurable residual disease but developed cerebellar toxicity after high dose cytarabine. He underwent successful matched sibling allogeneic stem cell transplant and is presently on routine follow up. This case report suggest possible role of this combination even in young patients unfit for intensive induction.

摘要

一部分急性髓系白血病(AML)患者在诊断时不适合进行7+3诱导化疗。本病例强调了阿扎胞苷和维奈克拉在一名具有WT-1突变的中危AML患者中的应用,鉴于患者一般状况较差和存在合并症,被认为不适合进行强化诱导化疗。使用维奈克拉和阿扎胞苷治疗后,患者可测量的残留病呈阴性,但在接受大剂量阿糖胞苷治疗后出现了小脑毒性。他成功接受了匹配的同胞异基因干细胞移植,目前正在进行常规随访。本病例报告表明,即使在不适合进行强化诱导化疗的年轻患者中,这种联合治疗方案也可能发挥作用。

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本文引用的文献

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Cerebellar toxicity with high-dose cytosine arabinoside.
J Clin Oncol. 1987 Jun;5(6):927-32. doi: 10.1200/JCO.1987.5.6.927.

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