Ehsan Hamid, Iqbal Qamar, Masood Adeel, Grunwald Michael R
Hematology/Oncology Fellow, Levine Cancer Institute/Atrium Health, Charlotte, NC, USA.
Internal Medicine - Tidal Health Peninsula Regional. 100 East Carroll Street, Salisbury, MD 21801, USA.
Leuk Res Rep. 2022 Aug 17;18:100345. doi: 10.1016/j.lrr.2022.100345. eCollection 2022.
Acute myeloid leukemia (AML) is a heterogeneous hematological malignancy characterized by clonal expansion of myeloid blasts. It is the most common type of acute leukemia in adults, including elderly patients, and has historically been associated with poor outcomes in this age group. Here, we present the case of an 80-year-old woman with newly diagnosed AML with myelodysplasia-related changes. She was treated with a total of five cycles of azacitidine, two cycles as monotherapy followed by three cycles in combination with venetoclax. Therapy was stopped due to cytopenias and declining performance status. Bone marrow aspirate and biopsy immediately following treatment and again approximately four months later did not show any morphologic, immunophenotypic, or cytogenetic evidence of leukemia. The patient's clinical and performance status improved significantly with time. Follow-up labs more than three years following the completion of treatment reveal continued hematologic remission. A short treatment course of azacitidine and venetoclax with close monitoring may lead to durable responses in some patients. Further studies are necessary to determine which patients might be appropriate for treatment suspension or discontinuation while in remission.
急性髓系白血病（AML）是一种异质性血液系统恶性肿瘤，其特征为髓系原始细胞的克隆性增殖。它是成人（包括老年患者）中最常见的急性白血病类型，历来与该年龄组的不良预后相关。在此，我们报告一例80岁新诊断为伴有骨髓增生异常相关改变的AML女性患者。她总共接受了五个周期的阿扎胞苷治疗，其中两个周期为单药治疗，随后三个周期与维奈克拉联合使用。由于血细胞减少和体能状态下降，治疗停止。治疗后立即进行的骨髓穿刺和活检以及大约四个月后再次进行的检查均未显示白血病的任何形态学、免疫表型或细胞遗传学证据。随着时间的推移，患者的临床和体能状态显著改善。治疗完成三年多后的随访实验室检查显示持续血液学缓解。短期的阿扎胞苷和维奈克拉治疗过程并密切监测可能会使部分患者获得持久缓解。需要进一步研究以确定哪些患者在缓解期可能适合暂停或终止治疗。
