Kim Mihee, Bang Hyun-Jin, Song Ga-Young, Ahn Seo-Yeon, Jung Sung-Hoon, Song Yong-Su, Ahn Jae-Sook
Hematology-Oncology, Chonnam National University Hwasun Hospital, Jeollanam-do, Republic of Korea.
Internal Medicine, Chonnam National University, Gwangju, Republic of Korea.
Electrolyte Blood Press. 2021 Dec;19(2):46-50. doi: 10.5049/EBP.2021.19.2.46. Epub 2021 Dec 23.
Combination treatment with hypomethylating agents (HMAs) and venetoclax is being used increasingly in elderly patients with acute myeloid leukemia (AML). Venetoclax with HMAs has been reported to be associated with tumor lysis syndrome (TLS) in AML patients with high leukemic burden. We present a case of an elderly AML patient with low leukemic burden who developed TLS while receiving venetoclax and azacitidine (AZA). A 74-year-old man with newly diagnosed AML with NPM1 mutation received combination therapy with venetoclax and AZA in an outpatient clinic. Within 12 hours after starting venetoclax and AZA, the patient was admitted to the emergency room with fever, general weakness, and laboratory findings consistent with TLS. Based on our results, we recommend monitoring at the start of the treatment with venetoclax and HMAs to prevent and control TLS regardless of the leukemic burden and favorable genetic risk.
去甲基化药物（HMAs）与维奈克拉联合治疗在老年急性髓系白血病（AML）患者中应用越来越多。据报道，维奈克拉与HMAs联合使用会使白血病负荷高的AML患者发生肿瘤溶解综合征（TLS）。我们报告1例白血病负荷低的老年AML患者在接受维奈克拉和阿扎胞苷（AZA）治疗时发生了TLS。一名74岁新诊断为NPM1突变型AML的男性患者在门诊接受了维奈克拉和AZA联合治疗。在开始使用维奈克拉和AZA后12小时内，患者因发热、全身无力以及与TLS相符的实验室检查结果被收入急诊室。根据我们的结果，我们建议在开始使用维奈克拉和HMAs治疗时进行监测，以预防和控制TLS，无论白血病负荷和有利的遗传风险如何。
