Guo Huimei, Ye Shaojie, Zhang Jiangbo, Zhao Songying, Wang Jing, Xu Jianmei, Wang Lin, Xue Hua
Department of Hematology, Affiliated Hospital of Hebei University, Baoding, China.
AME Case Rep. 2025 Jul 15;9:108. doi: 10.21037/acr-25-19. eCollection 2025.
Acute myeloid leukemia (AML) harboring mixed lineage leukemia () rearrangement typically presents with high malignancy, poor remission rates, susceptibility to relapse, and a dismal prognosis. For these patients, achieving rapid remission followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an important strategy, underscoring the importance of choosing the initial induction regimen. Mitoxantrone liposome (L-MIT) is a modified drug formulation that enhances anti-tumor activity and reduces toxicity. At present, there is no report on the efficacy and safety of the MEA regimen consisting of L-MIT combined with etoposide and cytarabine in patients with AML with rearrangement.
We described four patients with -rearranged AML who received L-MIT combined with etoposide and cytarabine (MEA) as induction therapy, evaluating efficacy and safety after one treatment cycle. Three patients achieved complete remission (CR), including two who reached minimal residual disease (MRD) negativity, and another patient achieved partial remission (PR). Currently, three patients received allo-HSCT, while one was in consolidation chemotherapy due to advanced age and financial limitations. The main adverse event was manageable myelosuppression, with one case remaining febrile without signs of infection, while the other three experienced varying degrees of infections. Gastrointestinal side effects were mild, with no liver or kidney damage, obvious cardiac toxicity, infusion reactions, or skin discoloration.
The L-MIT-based MEA regimen showed promising efficacy with a favorable safety profile in patients with -rearranged AML, suggesting that the MEA regimen could be one of the preferred therapeutic options for this population.
伴有混合谱系白血病（MLL）重排的急性髓系白血病（AML）通常具有高恶性、低缓解率、易复发及预后差的特点。对于这些患者，实现快速缓解并随后进行异基因造血干细胞移植（allo-HSCT）是一项重要策略，这凸显了选择初始诱导方案的重要性。米托蒽醌脂质体（L-MIT）是一种改良的药物制剂，可增强抗肿瘤活性并降低毒性。目前，尚无关于L-MIT联合依托泊苷和阿糖胞苷组成的MEA方案治疗伴有MLL重排的AML患者的疗效和安全性的报道。
我们描述了4例伴有MLL重排的AML患者，他们接受L-MIT联合依托泊苷和阿糖胞苷（MEA）作为诱导治疗，并在一个治疗周期后评估疗效和安全性。3例患者达到完全缓解（CR），其中2例达到微小残留病（MRD）阴性，另1例患者达到部分缓解（PR）。目前，3例患者接受了allo-HSCT，而1例因年龄较大和经济限制正在进行巩固化疗。主要不良事件是可控的骨髓抑制，1例持续发热但无感染迹象，另外3例经历了不同程度的感染。胃肠道副作用较轻，无肝肾功能损害、明显心脏毒性、输液反应或皮肤变色。
基于L-MIT的MEA方案在伴有MLL重排的AML患者中显示出有前景的疗效和良好的安全性，提示MEA方案可能是该人群的首选治疗方案之一。
