Treatment of STAT5b-RARA positive acute promyelocytic leukemia by Venetoclax combining with homoharringtonine, cytarabine: A case report and literature review.

IF 1.5 Q3 HEMATOLOGY
血液科学(英文) Pub Date : 2022-05-17 eCollection Date: 2022-04-01 DOI:10.1097/BS9.0000000000000111
Guangji Zhang, Yang Song, Li Wan, Kaiqi Liu, Shaowei Qiu, Jianxiang Wang, Yingchang Mi
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Abstract

Introduction: Acute promyelocytic leukemia (APL) is mostly due to the chromosome translocation t (15; 17) (q22; q12), leading to the formation of PML-RARA fusion protein. Some patients carried rare translocation involving RARA gene, who were called variant APL caused by RAR family (RARA, RARB, and RARG) and partner genes. STAT5b-RARA was a rare type of molecular genetic abnormality with unfavorable prognosis which have been reported in only 18 cases in variant APL. Knowledge of STAT5b-RARA (+) APL treatment is still limited.

Case report: We presented a 38-year-old female variant APL case, who was STAT5b-RARA positive detected by reverse transcription polymerase chain reaction. The patient failed to respond after four-drug combined induction chemotherapy: idarubicin, cytarabine, all trans retinoic acid, and arsenic trioxide (As2O3). Then, the patient was re-induced with azacytidine, but still failed to achieve complete remission (CR). Next, she was treated with Venetoclax combining with homoharringtonine and cytarabine as the salvage therapy and achieved CR. Later, the patient received hematopoietic stem cell transplantation after 4 cycles of consolidation therapy.

Conclusion: Venetoclax combining with homoharringtonine and cytarabine has been used as the salvage therapy in the STAT5b-RARA positive APL successfully.

Abstract Image

Abstract Image

Venetoclax联合高杉碱、阿糖胞苷治疗STAT5b-RARA阳性急性早幼粒细胞白血病1例并文献复习。
简介:急性早幼粒细胞白血病(APL)多由染色体易位t (15;17)(如;q12),导致PML-RARA融合蛋白的形成。部分患者携带罕见的涉及RARA基因易位,称为由RAR家族(RARA、RARB、RARG)及其伴侣基因引起的变异型APL。STAT5b-RARA是一种罕见的预后不良的分子遗传异常,仅在变异APL中有18例报道。关于STAT5b-RARA (+) APL治疗的知识仍然有限。病例报告:我们报告了一例38岁女性变异型APL病例,逆转录聚合酶链反应检测到STAT5b-RARA阳性。四种药物联合诱导化疗:伊达柔比星、阿糖胞苷、全反式维甲酸和三氧化二砷(As2O3)后,患者无反应。然后,患者再次用阿扎胞苷诱导,但仍未能达到完全缓解(CR)。随后给予Venetoclax联合高杉碱、阿糖胞苷为补救性治疗,达到CR。巩固治疗4个周期后,行造血干细胞移植。结论:Venetoclax联合高杉碱、阿糖胞苷是治疗STAT5b-RARA阳性APL的有效方法。
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
CiteScore
1.70
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