Successful treatment with blinatumomab for acute lymphoblastic leukemia in an older adult patient complicated with hepatocarcinoma

IF 0.7 Q4 HEMATOLOGY

Leukemia Research Reports Pub Date : 2024-01-01 DOI:10.1016/j.lrr.2024.100413

Masuho Saburi , Masanori Sakata , Rika Maruyama , Yousuke Kodama , Keiichi Uraisami , Hiroyuki Takata , Yasuhiko Miyazaki , Katsuya Kawano , Yasuhiro Kodama , Eiichi Ohtsuka

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Abstract

An 82-year-old man with Philadelphia chromosome-negative acute lymphoblastic leukemia (ALL) complicated by hepatocarcinoma was presented. Remission induction therapy of hyper-CVAD with half dose reduction achieved hematological complete remission (CR), but accompanied with elevated alanine aminotransferase and hyperbilirubinemia. The patient was thought intolerable for hyper-CVAD with half dose reduction due to liver toxicity, and treatment was switched to blinatumomab. Hematological CR was sustained after nine cycles of blinatumomab without exacerbation of liver dysfunction. After five courses of blinatumomab, hepatocarcinoma was treated successfully by trans-arterial chemoembolization. Two years after the diagnosis of ALL, the patient was alive in CR status of ALL.

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用 blinatumomab 成功治疗一名并发肝癌的老年急性淋巴细胞白血病患者

患者是一名 82 岁的男性，患有费城染色体阴性急性淋巴细胞白血病（ALL）并发肝癌。减半剂量的高CVAD缓解诱导治疗取得了血液学完全缓解（CR），但伴有丙氨酸氨基转移酶升高和高胆红素血症。由于肝脏毒性，该患者被认为不能耐受减半剂量的超CVAD治疗，因此改用blinatumomab治疗。经过9个周期的blinatumomab治疗后，血液学CR得以维持，肝功能异常没有加重。5个疗程的blinatumomab治疗后，经动脉化疗栓塞术成功治疗了肝癌。确诊为 ALL 两年后，患者仍以 ALL CR 状态存活。

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