Successful Treatment With Venetoclax Plus Azacytidine Combined With Radiation Therapy and Donor Lymphocyte Infusion in a Patient With Extramedullary Relapse of Acute Myeloid Leukemia After Stem Cell Transplantation

TL;DR

A patient with rare extramedullary relapse of AML after a stem cell transplant was successfully treated with a combination of venetoclax, azacytidine, radiation therapy, and donor lymphocyte infusion.

Contribution

This case report demonstrates the potential efficacy of combining venetoclax and azacytidine with radiation and donor lymphocyte infusion for post-transplant extramedullary AML relapse.

Findings

The combination therapy led to promising results in a patient with extramedullary AML relapse after stem cell transplantation.

Venetoclax and azacytidine showed efficacy in salvage treatment following radiation therapy and donor lymphocyte infusion.

Abstract

Extramedullary (EM) relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT) for acute myeloid leukemia (AML) is rare and causes systemic relapse. Consequently, the prognosis is very poor because limited treatment is feasible in post-transplant patients. The efficacy and safety of venetoclax (VEN), a newly developed oral inhibitor of B-cell leukemia/lymphoma-2, plus azacytidine (AZA) in patients newly diagnosed with AML who are ineligible for intensive chemotherapy have been reported. We report a case in which VEN + AZA salvage treatment following radiation therapy and donor lymphocyte infusion afforded promising results in a patient with AML who showed post-allo-HSCT EM relapse.

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