Takeda Takaaki, Suzuki Taisei, Enaka Makiko, Izumi Akihiko, Tachibana Takayoshi, Tanaka Masatsugu, Fujimaki Katsumichi, Nakajima Hideaki
Department of Hematology, Fujisawa City Hospital.
Department of Pathology, Fujisawa City Hospital.
Rinsho Ketsueki. 2024;65(10):1259-1264. doi: 10.11406/rinketsu.65.1259.
A 33-year-old man was diagnosed with acute myeloid leukemia (AML). He was treated with daunorubicin and cytarabine and achieved complete remission. He underwent consolidation therapy with three cycles of venetoclax and azacitidine (VEN+AZA). He received cord blood transplantation following a reduced-intensity conditioning (RIC) regimen. After 19 months, an extramedullary mass appeared in the paranasal sinuses along with vision loss, and relapsed AML was diagnosed based on a biopsy. Palliative irradiation was performed because the patient did not wish to receive a second transplantation. A painful extramedullary mass was found in the inguinal area, and radiation therapy was performed. Subsequently, extramedullary masses appeared in the submandibular region, but radiation therapy was not feasible because the irradiation field overlapped with that of the previous therapy. The extramedullary masses decreased after two cycles of VEN+AZA therapy. This is a rare report of VEN+AZA therapy for an extramedullary relapse of AML.
一名33岁男性被诊断为急性髓系白血病(AML)。他接受了柔红霉素和阿糖胞苷治疗并实现完全缓解。他接受了三个周期的维奈克拉和阿扎胞苷(VEN+AZA)巩固治疗。在接受减低强度预处理(RIC)方案后,他接受了脐血移植。19个月后,鼻窦出现髓外肿块并伴有视力丧失,经活检诊断为AML复发。由于患者不希望接受第二次移植,因此进行了姑息性放疗。在腹股沟区发现一个疼痛的髓外肿块,并进行了放射治疗。随后,下颌下区域出现髓外肿块,但由于照射野与先前治疗的照射野重叠,放射治疗不可行。经过两个周期的VEN+AZA治疗后,髓外肿块缩小。这是一篇关于VEN+AZA治疗AML髓外复发的罕见报道。