Drozd-Sokolowska Joanna, Mądry Krzysztof, Siewiorek Kinga, Feliksbrot-Bratosiewicz Magdalena, Stokłosa Tomasz, Gierej Beata, Stefaniak Agnieszka, Paszkowska-Kowalewska Małgorzata, Sokołowski Jacek, Sankowski Bartłomiej, Basak Grzegorz Władysław
Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.
Department of Immunology, Center for Biostructure Research, Medical University of Warsaw, Warsaw, Poland.
Chemotherapy. 2022;67(3):173-177. doi: 10.1159/000524182. Epub 2022 Mar 24.
A combination of azacitidine and venetoclax (AZA-VEN) has been approved for the treatment of adult treatment-naïve acute myeloid leukemia (AML) patients, ineligible for intensive chemotherapy. The protocol may also constitute an alternative for the treatment of patients with mixed phenotype acute leukemia (MPAL), for which no established treatment guidelines exist. It may be anticipated, that alike in AML or chronic lymphocytic leukemia, the treatment of MPAL may be complicated by the tumor lysis syndrome (TLS). No case of TLS in MPAL after VEN has been however reported so far. Here, we present a case of a patient with MPAL, who received AZA-VEN. The patient had a substantial bulk of disease with generalized lymphadenopathy and increased white blood cell count. Despite preventive measures, the patient developed the clinical TLS, which was successfully treated. Based on the current case and other published cases, the incidence of TLS after AZA-VEN was established at 17%.
阿扎胞苷和维奈克拉联合用药（AZA-VEN）已被批准用于治疗不适合强化化疗的初治成年急性髓系白血病（AML）患者。该方案也可能成为治疗混合表型急性白血病（MPAL）患者的一种替代方案，目前尚无针对MPAL的既定治疗指南。可以预期，与AML或慢性淋巴细胞白血病一样，MPAL的治疗可能会因肿瘤溶解综合征（TLS）而变得复杂。然而，迄今为止尚未报道VEN治疗后MPAL发生TLS的病例。在此，我们报告一例接受AZA-VEN治疗的MPAL患者。该患者有大量疾病，伴有全身淋巴结肿大和白细胞计数升高。尽管采取了预防措施，患者仍发生了临床TLS，但经成功治疗。基于本病例及其他已发表病例，AZA-VEN治疗后TLS的发生率确定为17%。
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