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T/myeloid mixed-phenotype acute leukemia treated with venetoclax and decitabine: A case report
Sungwoo Park1, Eun Jeong Jeong1, Jung Hun Kang1
1Division of Hematology and Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Gyeongsang National University, Jinju 52727, South Korea.
Background:
Mixed-phenotype acute leukemia (MPAL) is characterized by acute undifferentiated leukemia with blasts co-expressing myeloid and lymphoid antigens. However, consensus regarding the ideal management strategy for MPAL is yet to be established, owing to its rarity.
Case Summary:
A 55-year-old male was diagnosed with T/myeloid MPAL. Vincristine, prednisolone, daunorubicin, and L-asparaginase were administered as induction chemotherapy. Septic shock occurred 10 days after induction, and bone marrow examination following recovery from sepsis revealed refractory disease. Venetoclax and decitabine were administered as chemotherapy-free induction therapy to reduce the infection risk. There were no serious infections, including febrile neutropenia, at the end of the treatment. After receiving two additional cycles of venetoclax/decitabine, the patient underwent haploidentical peripheral blood stem-cell transplantation and achieved complete response (CR) to treatment.
Conclusion:
CR was maintained in a patient with MPAL who underwent haploidentical peripheral blood stem-cell transplantation after additional venetoclax/decitabine cycles.
Insights
This case study highlights a novel treatment approach for mixed-phenotype acute leukemia (MPAL). A patient achieved complete remission using venetoclax and decitabine followed by haploidentical stem cell transplant.
Area of Science:
- Hematology
- Oncology
- Immunology
Background:
- Mixed-phenotype acute leukemia (MPAL) presents a diagnostic challenge due to co-expression of myeloid and lymphoid antigens.
- The rarity of MPAL hinders the establishment of standardized treatment protocols.
- Optimal management strategies for MPAL remain under investigation.
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