Park S, Jeong EJ, Kang JH, Lee GW, Go SI, Lee DH, Koh EH. T/myeloid mixed-phenotype acute leukemia treated with venetoclax and decitabine: A case report. World J Clin Cases 2023; 11(26): 6200-6205 [PMID: 37731550 DOI: 10.12998/wjcc.v11.i26.6200]
Corresponding Author of This Article
Gyeong-Won Lee, MD, PhD, Professor, Division of Hematology and Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, 79 Gangnam-ro, Jinju-si, Gyeongsangnam-do 52727, South Korea. brightree@naver.com
Research Domain of This Article
Hematology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Sep 16, 2023; 11(26): 6200-6205 Published online Sep 16, 2023. doi: 10.12998/wjcc.v11.i26.6200
T/myeloid mixed-phenotype acute leukemia treated with venetoclax and decitabine: A case report
Sungwoo Park, Eun Jeong Jeong, Jung Hun Kang, Gyeong-Won Lee, Se-Il Go, Dong-Hyun Lee, Eun-Ha Koh
Sungwoo Park, Eun Jeong Jeong, Jung Hun Kang, Gyeong-Won Lee, Division 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
Se-Il Go, Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon 52828, South Korea
Dong-Hyun Lee, Eun-Ha Koh, Department of Laboratory Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Gyeongsang National University, Jinju 52828, South Korea
Author contributions: Park S was involved in the conception and design of the study, analyzed the data, and wrote the article; Jeong EJ, Kang JH, Lee DH, Koh EH, and Go SI performed the treatment, acquired the data, and revised the manuscript; Lee GW was involved in the conception and design of the study, critically revised the manuscript for important intellectual content, and gave final approval for the version to be submitted.
Informed consent statement: The requirement for informed consent was waived because the analysis used completely anonymous data; consent was obtained before performing any medical investigation or the start of treatment as required.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gyeong-Won Lee, MD, PhD, Professor, Division of Hematology and Oncology, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, 79 Gangnam-ro, Jinju-si, Gyeongsangnam-do 52727, South Korea. brightree@naver.com
Received: May 25, 2023 Peer-review started: May 25, 2023 First decision: June 15, 2023 Revised: July 24, 2023 Accepted: August 18, 2023 Article in press: August 18, 2023 Published online: September 16, 2023 Processing time: 106 Days and 5 Hours
Abstract
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.
Core Tip: We report a 55-year-old male diagnosed with T/myeloid mixed-phenotype acute leukemia (MPAL) who received induction chemotherapy with vincristine, prednisolone, daunorubicin, and L-asparaginase. The patient experienced septic shock 10 days post-induction therapy and received antibiotic therapy to treat extended-spectrum beta-lactamase-positive bacteremia. Bone marrow examination post-sepsis recovery revealed refractory disease. To reduce the infection risk, venetoclax and decitabine were administered as chemotherapy-free induction therapy. After two additional venetoclax/decitabine cycles, the patient underwent haploidentical peripheral blood stem-cell transplantation, subsequently achieving complete response. This is the third report documenting the successful treatment of refractory T/myeloid MPAL with venetoclax and a hypomethylating agent.
