Venetoclax and azacitidine in combination with homoharringtonine, cytarabine, and aclarubicin for salvage therapy of relapsed/refractory T cell acute lymphoblastic leukemia.
Lin-Sen Feng, Hui-Yuan Li, Ai Tang, Meng-Li Xu, San-Bin Wang
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Abstract
Background: The treatment of relapsed/refractory T cell acute lymphoblastic leukemia (R/R T-ALL) is a significant challenge in hematologic oncology, and no standard salvage treatment plan exists. Both Chinese and international clinical guidelines recommend combination chemotherapy including venetoclax.
Methods: Efficacy and safety of venetoclax, azacitidine, homoharringtonine, cytarabine, and aclarubicin (VA-HAA) combination therapy were retrospectively analyzed in 3 patients with R/R T-ALL at the Department of Hematology, 920th Hospital of the Joint Logistics Support Force, Chinese People's Liberation Army.
Results: The chemotherapy resulted in CR/CRi with negative flow MRD in all 3 patients. Quantitative negative conversion was achieved in 2 patients with fusion genes, and the frequency of monoclonal TCR gene rearrangements was significantly reduced in 1 patient. All patients received stem cell rescue after the chemotherapy. Hematologic toxicity may be manageable, with a median of 24 days for complete recovery of neutrophils (ANC) and 36 days for partial recovery of platelets. There were no major bleeding events or chemotherapy-related deaths.
Conclusion: VA-HAA may be an effective and safe salvage treatment for R/R T-ALL, and prospective clinical trials are needed to verify its specific clinical efficacy.
期刊介绍：
The International Journal of Hematology, the official journal of the Japanese Society of Hematology, has a long history of publishing leading research in hematology. The journal comprises articles that contribute to progress in research not only in basic hematology but also in clinical hematology, aiming to cover all aspects of this field, namely, erythrocytes, leukocytes and hematopoiesis, hemostasis, thrombosis and vascular biology, hematological malignancies, transplantation, and cell therapy. The expanded [Progress in Hematology] section integrates such relevant fields as the cell biology of stem cells and cancer cells, and clinical research in inflammation, cancer, and thrombosis. Reports on results of clinical trials are also included, thus contributing to the aim of fostering communication among researchers in the growing field of modern hematology. The journal provides the best of up-to-date information on modern hematology, presenting readers with high-impact, original work focusing on pivotal issues.
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