[Successful treatment with venetoclax and azacitidine in a patient with acute myeloid leukemia with BCR::ABL1 fusion].

Abstract

An 80-year-old woman presented with fatigue. Routine blood tests at her previous medical institution revealed a decreased white blood cell count, leading to a diagnosis of low-risk myelodysplastic syndrome. During observation, the disease progressed to acute myeloid leukemia (AML), and she was subsequently referred to our hospital. At the time of AML diagnosis, bone marrow examination detected minor BCR-ABL mRNA. Fluorescence in situ hybridization showed a positive BCR-ABL fusion signal in 7.5% of bone marrow cells. Treatment with venetoclax and azacitidine was initiated, and led to hematological remission after one cycle. A bone marrow examination after two cycles confirmed the maintenance of hematological remission, and RT-PCR showed reduced minor BCR-ABL mRNA levels. AML with BCR-ABL1 fusion generally has a poor prognosis and has no established treatment, but in this case, treatment with venetoclax and azacitidine successfully induced remission and demonstrated potential efficacy against BCR-ABL fusion-positive clones.