Complete Response (CR) in a Previously-progressing Chronic Lymphocytic Leukemia (CLL) Patient Treated With Methionine Restriction in Combination With First-line Chemotherapy.

Cancer diagnosis & prognosis Pub Date : 2025-01-03 eCollection Date: 2025-01-01 DOI:10.21873/cdp.10407

Sei Morinaga, Qinghong Han, Kohei Mizuta, Byung Mo Kang, Norio Yamamoto, Katsuhiro Hayashi, Hiroaki Kimura, Shinji Miwa, Kentaro Igarashi, Takashi Higuchi, Hiroyuki Tsuchiya, Satoru Demura, Robert M Hoffman

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Abstract

Background/aim: Chronic lymphocytic leukemia (CLL) is currently incurable. CLL is characterized by disordered DNA methylation. The aim of the present study was to target methylation with methionine restriction in a patient with progressive CLL.

Case report: Methionine restriction for the patient was achieved with a low-methionine vegan diet and oral recombinant methioninase (o-rMETase). The patient also received rituximab, once per week for four weeks, and acalabrutinib 100 mg, twice daily (bid) continuously. The patient's white blood cell count decreased by 95% from peak levels and extensive lymphadenopathy disappeared during combination treatment with o-rMETase, rituximab, and acalabrutinib.

Conclusion: The combination of methionine restriction and first-line chemotherapy resulted in an apparent complete response (CR) in a CLL patient, a rare event. The duration of the CR will be monitored, and additional CLL patients will be treated similarly in the future.

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甲硫氨酸限制联合一线化疗治疗前进展性慢性淋巴细胞白血病患者的完全缓解（CR）

背景/目的：慢性淋巴细胞白血病（CLL）目前是无法治愈的。CLL的特征是DNA甲基化紊乱。本研究的目的是针对进行性CLL患者的甲基化与蛋氨酸限制。病例报告：患者通过低蛋氨酸纯素饮食和口服重组蛋氨酸酶（o-rMETase）来限制蛋氨酸。患者同时接受利妥昔单抗治疗，每周1次，连续4周，阿卡拉布替尼100mg，每日2次（bid）。在o-rMETase、利妥昔单抗和阿卡拉布替尼联合治疗期间，患者的白细胞计数从峰值水平下降了95%，广泛的淋巴结病消失。结论：甲硫氨酸限制和一线化疗联合治疗CLL患者出现了明显的完全缓解（CR），这是一种罕见的事件。将监测CR的持续时间，未来将对其他CLL患者进行类似的治疗。

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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Cancer diagnosis & prognosis

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