Sustained Complete Remission with Incomplete Hematologic Recovery (CRi) in a Patient with Relapsed AML and Concurrent BCR-ABL1 and CBFB Rearrangement Treated with a Combination of Venetoclax and 5-Azacytidine

Abstract

The co-occurrence of BCR-ABL1 fusion and core-binding factor (CBF) rearrangements is uncommonly reported in AML. Although CBF rearrangements carry a favorable prognosis, the coexistence of BCR-ABL1 is associated with aggressive disease suggesting a potential advantage of high-intensity chemotherapy in association with tyrosine kinase inhibitors. Herein, we describe a refractory AML patient harboring BCR-ABL1 fusion and CBFB rearrangement that was successfully treated with a combination of venetoclax and hypomethylating agent.

Hypomethylating agent monotherapy in core binding factor acute myeloid leukemia: a French multicentric retrospective study

“…The study VIALE-A demonstrated that association of azacitidine with BCL2 inhibitor venetoclax improves patients OS, leading to the recent approval of this combination for newly diagnosed AML in intensive chemotherapy ineligible patients [ 32 ]. Nevertheless, CBF-AML were also excluded from this study, and no clue is currently available for the efficacy of azacitidine + venetoclax combination in this AML subgroup, with the exception of one case report [ 56 ]. HMA may also be associated with other drugs whose anti-leukemic activity in CBF-AML have been suggested, such as gemtuzumab-ozogamicin [ 26 , 57 ], or tyrosine-kinase inhibitors dasatinib [ 58 , 59 ] or midostaurin [ 60 ].…”

Hyaluronic Acid Nanoparticles for Immunogenic Chemotherapy of Leukemia and T-Cell Lymphoma

“…Over the past couple of decades, significant effort has gone into understanding the biological basis of blood cancers. This accelerated the development and use of drug cocktails in clinical oncology [1][2][3][4][5][6][7][8][9]. The general guidelines for using such cocktails largely remain focused on combining (a) drugs with different mechanisms of action to counter multidrug resistance and (b) drugs with non-overlapping toxicities for administration at near-maximal dose [10][11][12][13].…”

Concurrent BCR‐ABL1 and core binding factor beta rearrangement in de novo acute myeloid leukemia: A case report and review of literature

“…The co-occurrence of CBFB and BCR-ABL1 rearrangements in AML represents a distinct subgroup with unique clinical and molecular features. To date, there have been less than 30 cases reported in the literature [1,[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]. This intriguing association, while rare, poses a unique diagnostic and therapeutic challenge, as the treatment strategies for CML and AML markedly differ.…”