Venetoclax in Combination with Decitabine for Relapsed T-Cell Acute Lymphoblastic Leukemia after Allogeneic Hematopoietic Cell Transplant.
Venetoclax in Combination with Decitabine for Relapsed T-Cell Acute Lymphoblastic Leukemia after Allogeneic Hematopoietic Cell Transplant.
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DOI：
10.1155/2018/6092646
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发表时间：
2018
影响因子：
0.7
通讯作者：
Mannis GN
中科院分区：
文献类型：
--
作者：
Rahmat LT;Nguyen A;Abdulhaq H;Prakash S;Logan AC;Mannis GN
成人T细胞急性淋巴细胞白血病（T-ALL）患者的长期无病生存率仍然很低，特别是复发后，几乎没有可用的补救方案。临床前数据表明，单独或与其他药物联合抑制抗凋亡蛋白BCL-2（B细胞淋巴瘤2）可能是治疗T-ALL的独特治疗方法。我们报告一例年轻男性T-ALL患者，在异基因造血干细胞移植后复发，在联合维奈托克和地西他滨的挽救治疗后获得第二次完全缓解。通过下一代测序对可测量的残留疾病进行评估，没有证据表明残留疾病的灵敏度为1 × 10−6。虽然维奈托克和低甲基化药物的组合在治疗复发性/难治性AML中显示出前景，但据我们所知，这是该组合在复发性/难治性T-ALL中证明临床活性的第一份报告。
Long-term disease-free survival in adults with T-cell acute lymphoblastic leukemia (T-ALL) remains poor, particularly after relapse, with few available salvage options. Preclinical data suggest that inhibition of the antiapoptotic protein BCL-2 (B-cell lymphoma 2) either alone or in combination with other agents, may be a unique therapeutic approach for the treatment of T-ALL. We present a case of a young male with T-ALL, relapsed after allogeneic hematopoietic stem cell transplant, who achieved a second complete remission following salvage therapy with combined venetoclax and decitabine. Assessment of measurable residual disease by next generation sequencing showed no evidence of residual disease of a sensitivity of 1 × 10−6. While the combination of venetoclax and hypomethylating agents has shown promise in the treatment of relapsed/refractory AML, and to our knowledge, this is the first report of this combination demonstrating clinical activity in relapsed/refractory T-ALL.