Effective Treatment with Venetoclax and Hypomethylating Agents for the Coexistence of Multiple Myeloma and Acute Myeloid Leukemia: A Case Report and Literature Review.

IF 1.1 4区医学 Q4 MEDICAL LABORATORY TECHNOLOGY

Annals of clinical and laboratory science Pub Date : 2024-07-01

Yu Chen, Feng-Hong Zhang, Mo Zhou, Chun-Xiao Hou, Chun-Li Xu, Qian Wang, Su-Ning Chen

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引用次数: 0

Abstract

Objective: Multiple myeloma (MM) and Acute myeloid leukemia (AML) are distinct hematologic malignancies originating from different cell lineages. Their coexistence is extremely rare, and current treatment approaches are even more so. Therefore, exploring the clinical features of their coexistence and the promising treatment strategy is worthwhile.

Case report: We described three cases involving the coexistence of MM and DNMT3A-mutant AML, two of which presented simultaneous occurrences, while Case 3 had secondary AML about 70 months after the MM.

Discussion: All cases exhibited DNMT3A mutations, which characterized by one missense mutation and two frameshift mutations; all were likely loss of function mutations. Among them, two patients were treated with Venetoclax-based regimens and achieved favorable effects. The patients were alive for 62,38 and 103 months.

Conclusions: Clonal hematopoiesis of DNMT3A may have a crucial role in the coexistence of MM and AML and Venetoclax-based regimens reveal favorable treatment responses. However, drug resistance still needs to be considered, and further research is required to elucidate the underlying mechanisms and treatment strategies.

本刊更多论文

使用 Venetoclax 和低甲基化药物有效治疗多发性骨髓瘤和急性髓性白血病并存：病例报告与文献综述

目的：多发性骨髓瘤（MM）和急性髓性白血病（AML）是源自不同细胞系的不同血液恶性肿瘤。它们同时存在的情况极为罕见，目前的治疗方法更是如此。因此，探讨它们共存的临床特征和有前景的治疗策略是值得的：我们描述了三例 MM 和 DNMT3A 突变 AML 共存的病例，其中两例同时发生，而病例 3 在 MM 发生后约 70 个月继发 AML：所有病例均出现 DNMT3A 突变，其中一个为错义突变，两个为框移突变；所有突变均可能为功能缺失突变。其中，两名患者接受了以 Venetoclax 为基础的治疗方案，并取得了良好疗效。这些患者分别存活了62、38和103个月：DNMT3A的克隆性造血可能在MM和AML并存的过程中起着至关重要的作用，基于Venetoclax的治疗方案显示出良好的治疗反应。然而，耐药性仍需考虑，需要进一步研究以阐明其潜在机制和治疗策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of clinical and laboratory science 医学-医学实验技术

CiteScore

1.60

自引率

0.00%

发文量

112

审稿时长

6-12 weeks

期刊介绍： The Annals of Clinical & Laboratory Science welcomes manuscripts that report research in clinical science, including pathology, clinical chemistry, biotechnology, molecular biology, cytogenetics, microbiology, immunology, hematology, transfusion medicine, organ and tissue transplantation, therapeutics, toxicology, and clinical informatics.