Central nervous system relapse of acute promyelocytic leukemia treated by oral Venetoclax with Azacitidine achieved complete remission

Li, Yanling; Dai, Haibin; Yao, Dandan; Gao, Xinyu; Xue, Yanming; Wang, Wei

doi:10.1007/s00277-022-04823-w

Cited by 3 publications

(1 citation statement)

References 5 publications

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“…Zhang et al demonstrated that venetoclax with IT injection support resulted in remission in patients with PML::RARA-positive APL showing CNS relapse [7]. Li et al showed that patients with PML::RARA-positive APL who were treated with venetoclax and azacitidine after a negative response to chemotherapy achieved CR [11]. Venetoclax is effective for patients with chronic lymphocytic leukemia involving the CNS [10,12].…”

Section: Discussionmentioning

confidence: 99%

Treatment of central nervous system relapse in PLZF::RARA-positive acute promyelocytic leukemia by venetoclax combined with arubicin and cytarabine: a case report

Zhou

Zhu

Wang

et al. 2023

Preprint

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Background: Patients with refractory acute promyelocytic leukemia and central nervous system relapse often have a poor prognosis. Among them, patients with the PLZF::RARA rearrangement have a poor response to all-trans retinoic acid and conventional chemotherapy. Venetoclax, a selective inhibitor of B-cell lymphoma-2 (BCL-2), can cross the blood–brain barrier and has been widely used in the treatment of acute myeloid leukemia in recent years. Case presentation: We report a case of central nervous system relapse in a patient with acute promyelocytic leukemia with PLZF::RARA rearrangement who achieved complete remission after treatment with anthracycline cytotoxic chemotherapy in combination with venetoclax. The concentration of venetoclax in the cerebrospinal fluid (CSF) was found to be approximately 1/1000 of that in the plasma based on liquid chromatography–tandem mass spectrometry. After the first treatment course, the PLZF::RARA test result for the patient’s marrow fluid sample turned negative. After the third treatment course, abnormal promyelocytic leukemia cells in the CSF were not detected using flow cytometry, and the PLZF::RARA test in the CSF remained negative. Conclusion: This case report highlights a new approach to the treatment of central nervous system relapse in patients with PLZF::RARA-positive acute promyelocytic leukemia.

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Section: Discussionmentioning

confidence: 99%

Treatment of central nervous system relapse in PLZF::RARA-positive acute promyelocytic leukemia by venetoclax combined with arubicin and cytarabine: a case report

Zhou

Zhu

Wang

et al. 2023

Preprint

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All-trans retinoic acid enhanced the antileukemic efficacy of ABT-199 in acute myeloid leukemia by downregulating the expression of S100A8

Li²,

Cheng³

et al. 2022

International Immunopharmacology

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Treatment of central nervous system relapse in PLZF::RARA-positive acute promyelocytic leukemia by venetoclax combined with arubicin, cytarabine and intrathecal therapy: a case report

Zhou,

Zhu,

Wang

et al. 2023

Oncologie

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Objectives Patients suffering from refractory acute promyelocytic leukemia with central nervous system relapse often have a poor prognosis. Among these patients, those with PLZF::RARA rearrangement exhibit poor responses to all-trans retinoic acid and conventional chemotherapy. Venetoclax, a selective inhibitor of B-cell lymphoma-2, can cross the blood–brain barrier and has been widely applied to acute myeloid leukemia therapy recently. Case presentation A case of central nervous system relapse in a patient with acute promyelocytic leukemia harboring PLZF::RARA rearrangement was successfully treated with anthracycline cytotoxic chemotherapy and cytarabine in combination with venetoclax, resulting in complete remission. Liquid chromatography-tandem mass spectrometry revealed that the concentration of venetoclax in the cerebrospinal fluid (CSF) was approximately 1/1,000 of that in plasma. Following the first treatment course, the patient’s bone marrow sample tested negative for PLZF::RARA. After the third treatment course, abnormal promyelocytic leukemia cells in the CSF were not detected using flow cytometry, and the PLZF::RARA test in the CSF remained negative. Conclusions This case report highlights a new approach for the treatment of central nervous system relapse in patients with PLZF::RARA-positive acute promyelocytic leukemia.

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Central nervous system relapse of acute promyelocytic leukemia treated by oral Venetoclax with Azacitidine achieved complete remission

Cited by 3 publications

References 5 publications

Treatment of central nervous system relapse in PLZF::RARA-positive acute promyelocytic leukemia by venetoclax combined with arubicin and cytarabine: a case report

Treatment of central nervous system relapse in PLZF::RARA-positive acute promyelocytic leukemia by venetoclax combined with arubicin and cytarabine: a case report

All-trans retinoic acid enhanced the antileukemic efficacy of ABT-199 in acute myeloid leukemia by downregulating the expression of S100A8

Treatment of central nervous system relapse in PLZF::RARA-positive acute promyelocytic leukemia by venetoclax combined with arubicin, cytarabine and intrathecal therapy: a case report

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