A Case of Relapsed/Refractory CD56-Positive Acute Promyelocytic Leukemia, in Which Complete Molecular Remission Was Achieved Following Combination Therapy with Venetoclax and Azacitidine

Gan To Kagaku Ryoho. 2024 Mar;51(3):291-297.

Abstract

An 84-year-old woman was diagnosed as having acute promyelocytic leukemia(APL)in July Year X-3. The test for promyelocytic leukemia- retinoic acid receptor alpha(PML-RARA)mRNA was positive, while that for CD56 was negative. Since her white blood cell( WBC) count was <3,000/μL, with a count of APL cells of <1,000/μL, she was started on monotherapy with all-trans retinoic acid(ATRA). In September Year X-3, complete hematological remission(CHR)was confirmed. she refused to provide consent for receiving consolidation therapy. In February Year X-2, hematological relapse occurred. She was started on re-induction therapy with arsenite(ATO), and in June Year X-2, complete molecular remission(CMR)was achieved. She was started on post-remission therapy with ATO. In August Year X-1, she developed molecular relapse and was started on tamibarotene(Am80). In October Year X-1, hematological relapse was detected, and the test for CD56 was positive. She was started on combined venetoclax(VEN)+azacitidine(AZA)(VEN+AZA). After completion of 1 course of treatment, CMR was achieved, but she developed hematological relapse after 5 courses of treatment. She died of gastrointestinal hemorrhage. This is considered a valuable case for accumulating information on the treatment of CD56-positive APL resistant to ATRA and ATO.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Arsenic Trioxide / therapeutic use
  • Azacitidine / therapeutic use
  • Bridged Bicyclo Compounds, Heterocyclic*
  • Female
  • Humans
  • Leukemia, Promyelocytic, Acute* / drug therapy
  • Recurrence
  • Sulfonamides*
  • Tretinoin / therapeutic use

Substances

  • Arsenic Trioxide
  • venetoclax
  • Azacitidine
  • Tretinoin
  • Sulfonamides
  • Bridged Bicyclo Compounds, Heterocyclic